Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Plasma leptin concentrations and obesity in relation to insulin resistance syndrome components among school children in Taiwan—The Taipei Children Heart Study

Abstract

OBJECTIVE: Leptin, an adipose tissue-derived product of the obesity (OB) gene, is an important regulator of energy metabolism and may be associated with the occurrence of insulin resistance and diabetes in humans. The purpose of this study was to evaluate the association of plasma leptin concentration with obesity and the components of insulin resistance syndrome (IRS) among school children in Taiwan.

METHODS: After multistage sampling of 85 junior high schools in Taipei, we randomly selected 1264 children (617 boys and 647 girls) aged 12–16 y. Obesity measurements included body mass index (BMI) and waist-to-hip circumference ratio (WHR). We calculated an IRS summary score for each individual by adding the quartile ranks from the distribution of systolic blood pressure (BP), serum triglyceride (TG), HDL-cholesterol (inverse), and insulin levels.

RESULTS: Boys had a higher BMI and WHR, BP and IRS score and lower leptin, insulin, TG and HDL-C levels than girls. BMI, WHR and plasma leptin levels were significantly associated with the IRS summary score and each of its components in both genders. Children with higher plasma leptin levels (>75th percentiles) have significantly higher BP, TG, insulin levels and IRS score than children with low leptin levels. The associations between plasma leptin level and the IRS components and score were still significant after adjusting for BMI in boys, but less so in girls. In both genders, after adjusting for WHR, plasma leptin levels were still significantly associated with the IRS components and summary score (P<0.001). The final model that included the standard covariates, BMI and leptin, but not WHR, was the most predictive of the IRS summary score among school children.

CONCLUSIONS: Insulin resistance syndrome in childhood, characterized by high blood pressure, dyslipidemia, and hyperinsulinemia, may be an early marker of cardiovascular risk. From the present BMI and leptin in combination are the most predictive markers of insulin resistance syndrome among school children in Taiwan.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

References

  1. Modan M, Halkin H, Almog S, Lusky A, Eshkol A, Shefi M, Shitrit A, Fuchs Z . Hyperinsulinemia: a link between hypertension, obesity and glucose intolerance J Clin Invest 1985 75: 809–817.

    CAS  Article  Google Scholar 

  2. Reaven GM . Banting lecture 1988: Role of insulin resistance in human disease Diabetes 1988 37: 1595–1607.

    CAS  Article  Google Scholar 

  3. Haffner SM, Valdez RA, Hazuda HP, Mitchell BD, Morales PA, Stern MP . Prospective analysis of the insulin resistance syndrome (syndrome X) Diabetes 1992 41: 715–722.

    CAS  Article  Google Scholar 

  4. Reaven GM, Laws A . Insulin resistance, compensatory hyperinsulinemia, and coronary heart disease Diabetolgia 1994 37: 948–952.

    CAS  Article  Google Scholar 

  5. Despres JP, Lamarche B, Mauriege P, Cantin B, Dagenais GR, Moorjani S, Lupien PJ . Hyperinsulinemia as an independent risk factor for ischemic heart disease New Engl J Med 1996 334: 952–957.

    CAS  Article  Google Scholar 

  6. Meigs JB, D'Agostino RB, Wilson PWF, Cupples LA, Nathan DM, Singer DE . Risk variable clustering in the insulin resistance syndrome. The Framingham Offspring Study Diabetes 1997 46: 1594–1600.

    CAS  Article  Google Scholar 

  7. Raitakari OT, Porkka KVK, Ronnemaa T, Knip M, Huari M, Akerblom HK, Viikari JSA . The role of insulin in clustering of serum lipids and blood pressure in children and adolescent Diabetologia 1995 38: 1042–1050.

    CAS  Article  Google Scholar 

  8. Bao W, Srinivasan SR, Wattigney WA, Berenson GS . Persistence of multiple cardiovascular risk clustering related to syndrome X from childhood to young adulthood. The Bogalusa Heart Study Arch Intern Med 1994 154: 1842–1847.

    CAS  Article  Google Scholar 

  9. Bao W, Srinivasan SR, Berenson GS . Persistent elevation of plasma insulin levels is associated with increased cardiovascular risk in children and young adults. The Bogalusa Heart Study Circulation 1996 93: 54–59.

    CAS  Article  Google Scholar 

  10. Arslanian S, Suprasongsin C . Insulin sensitivity, lipids, and body composition in childhood: is ‘syndrome X’ present? J Clin Endocrinol Metab 1996 81: 1058–1062.

    CAS  Article  Google Scholar 

  11. Srinivasan SR, Myers L, Berenson GS . Temporal association between obesity and hyperinsulinemia in children, adolescents, and young adults: the Bogalusa Heart Study Metab Clin Exp 1999 48: 928–934.

    CAS  Article  Google Scholar 

  12. NECP Expert Panel on Blood Cholesterol Levels in Children and Adolescents . National Cholesterol Education Program (NCEP): highlights of the report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents Pediatrics 1992 89: 495–501.

    Google Scholar 

  13. American Academy of Pediatrics, Committee on Nutrition . Statement on cholesterol Pediatrics 1992 90: 469–473.

    Google Scholar 

  14. Zhang Y, Proenca R, Maffel M, Barone M, Leopold L, Friedman JM . Positional cloning of the mouse obese gene and its human homologue Nature 1994 372: 425–432.

    CAS  Article  Google Scholar 

  15. Pelleymounter MA, Cullen MJ, Baker MB, Hecht R, Winters D, Boone T, Collins F . Effects of the obese gene product on body weight regulation in ob/ob mice Science 1995 269: 540–543.

    CAS  Article  Google Scholar 

  16. Auwerx J, Staels B . Leptin Lancet 1998 351: 737–742.

    CAS  Article  Google Scholar 

  17. Friedman JM . Leptin, leptin receptors, and the control of body weight Nutr Rev 1998 56: S38–S46.

    CAS  Article  Google Scholar 

  18. Zimmet P, Hodge A, Nicolson M, Staten M, de Courten M, Moore J, Morawiecki A, Lubina J, Collier G, Alberti G, Dowse G . Serum leptin concentration, obesity and insulin resistance in Western Samoans: cross sectional study BMJ 1996 313: 965–969.

    CAS  Article  Google Scholar 

  19. Segal KR, Landt M, Klein S . Relationship between insulin sensitivity and plasma leptin concentration in lean and obese men Diabetes 1996 45: 988–991.

    CAS  Article  Google Scholar 

  20. Caprio S, Tamboriane WV, Silver D, Robinson C, Leibel R, McCarthy S, Grozman A, Belous A, Maggs D, Sherwin RS . Hyperleptinemia: an early sign of juvenile obesity. Relations to body fat depots and insulin concentrations Endocrinol Metab 1996 34: E626–E630.

    Google Scholar 

  21. Cohen B, Novick D, Rubinstein M . Modulation of insulin activities by leptin Science 1996 274: 1185–1188.

    CAS  Article  Google Scholar 

  22. Vettor R, De Pergola G, Pagano C, Englaro P, Laudadio E, Giorgino F, Blum WF, Giorgino R and Federspil G . Gender difference in serum leptin in obese people?: Relationships with testosterone, body fat distribution and insulin sensitivity Eur J Clin Invest 1997 27: 1016–1024.

    CAS  Article  Google Scholar 

  23. Haffner SM, Miettinen H, Mykkanen L, Karhapaa P, Rainwater DL, Laakso M . Leptin concentrations and insulin sensitivity in normoglycemic men Int J Obes Relat Metab Disord 1997 21: 393–399.

    CAS  Article  Google Scholar 

  24. Mantzoros CS, Moschos S, Avramopoulos I, Kaklamani V, Liolios A, Doulgerakis DE, Griveas I, Katsilambros N, Flier JS . Leptin concentrations in relation to body mass index and the tumor necrosis factor-α system in humans J Clin Endocrinol Metab 1997 82: 3408–3413.

    CAS  PubMed  Google Scholar 

  25. Zimmet PZ, Collins VR, de Couten MP, Hodge AM, Collier GR, Dowse GK, Alberti KGMM, Tuomilehto J, Hemraj F, Gareeboo H, Chitson P, Fareed D . Is there a relationship between leptin and insulin sensitivity independent of obesity? A population-based study in the Indian Ocean nation of Mauritius Int J Obes Relat Metab Disord 1998 22: 171–177.

    CAS  Article  Google Scholar 

  26. Leyva F, Godsland IF, Ghatei M, Proudler AJ, Aldis S, Walton C, Bloom S, Stevenson JC . Hyperleptinemia as a component of a metabolic syndrome of cardiovascular risk Artherioscler Thromb Vasc Biol 1998 18: 928–933.

    CAS  Article  Google Scholar 

  27. Haynes WG, Morgan DA, Walsh SA, Sivitz WI, Mark AL . Cardiovascular consequences of obesity: role of leptin Clin Exp Pharmac Phys 1998 25: 65–69.

    CAS  Article  Google Scholar 

  28. Leonhardt W, Horn R, Brabant G, Breidert M, Temelkova-Kurktschiev Th, Fucker K, Hanefeld M . Relation of free and specifically bond leptin to insulin secretion in patients with impaired glucose tolerance (IGT) Exp Clin Endocrinol Diabetes 1999 107: 46–52.

    CAS  Article  Google Scholar 

  29. Ronnemaa T, Knip M, Lautala P, Viikari J, Uhari M, Leino A, Kaprio EA, Salo MK, Dahl M, Nuutinen EM . Serum insulin and other cardiovascular risk indicators in children, adolescents and young adults Ann Med 1991 23: 67–72.

    CAS  Article  Google Scholar 

  30. Berenson GS, Radhakrishnamurthy B, Bao W, Srinivasan SR . Does adult-onset diabetes mellitus begin in childhood?: The Bogalusa Heart Study Am J Med Sci 1995 310 (Suppl 1): S77–S82.

    Article  Google Scholar 

  31. Schwartz MW, Prigeon RL, Kahn SE, Nicolson M, Moore J, Morawiecki A, Boyko EJ, Porte D Jr . Evidence that plasma leptin and insulin levels are associated with body adiposity via different mechanisms Diabetes Care 1997 20: 1476–1481.

    CAS  Article  Google Scholar 

  32. Arslanian S, Suprasongsin C, Kalhan SC, Drash AL, Brna R, Janosky JE . Plasma leptin in children: relationship to puberty, gender, body composition, insulin sensitivity, and energy expenditure Metab Clin & Exp 1998 47: 309–312.

    CAS  Article  Google Scholar 

  33. Chu NF, Rimm EB, Wang DJ, Liou HS, Shieh SM . Relationship between anthropometric variable and lipid levels among school children: the Taipei Children Heart Study Int J Obes Relat Metab Disord 1998 22: 66–72.

    CAS  Article  Google Scholar 

  34. Chu NF, Rimm EB, Wang DJ, Liou HS, Shieh SM . Clustering of cardiovascular disease risk factors among obese schoolchildren: the Taipei Children Heart Study Am J Clin Nutr 1998 67: 1141–1146.

    CAS  Article  Google Scholar 

  35. Richmond W . Preparation and properties of a cholesterol oxidase from Nocardia sp. and its application to the enzymatic assay of total cholesterol in serum Clin Chem 1973 19: 1350–1356.

    CAS  PubMed  Google Scholar 

  36. Stavropoulos WS, Crouch RD . A new colorimetric procedure for the determination of serum triglyceride Clin Chem 1974 20: 857.

    Google Scholar 

  37. Warnick GR . Benderson J, Albers JJ. Dextran sulfate-Mg precipitation procedure for quantification of high density lipoprotein-cholesterol Clin Chem 1982 28: 1379–1388.

    CAS  PubMed  Google Scholar 

  38. Ma Z, Gingerich RL, Santiago JV, Klein S, Smith CH, Landt M . Radioimmunoassay of leptin in human plasma Clin Chem 1996 42: 942–946.

    CAS  PubMed  Google Scholar 

  39. Friedewald WT, Levy R, Fredrickson DS . Estimation of the concentration of low density lipoprotein-cholesterol in plasma without use of the preparative ultracentrifuge Clin Chem 1972 18: 499–502.

    CAS  Google Scholar 

  40. Fontbonne A, Charles MA, Thibult N, Richard JL, Claude JR, Warnet JM, Rosselin GE, Eschwege E . Hyperinsulinaemia as a predictor of coronary heart disease mortality in a healthy population: the Paris Prospective Study, 15-year follow-up Diabetolgia 1991 34: 356–361.

    CAS  Article  Google Scholar 

  41. Mitchell BD, Haffner SM, Hazuda HP, Valdez R, Stern MP . The relations between serum insulin levels and 8 y changes in lipid, lipoprotein, and blood pressure levels Am J Epidemiol 1992 136: 12–22.

    CAS  Article  Google Scholar 

  42. Smoak CG, Burke GL, Webber LS, Harsha DW, Srinivasan SR, Berenson GS . Relation of obesity to clustering of cardiovascular disease risk factors in children and young adults. The Bogalusa Heart Study Am J Epidemiol 1987 125: 364–372.

    CAS  Article  Google Scholar 

  43. Hassink SG, Sheslow DV, de Lancey E, Opentanova I, Considine RV, Caro JF . Serum leptin in children with obesity: Relationship to gender and development Pediatrics 1996 98: 201–203.

    CAS  PubMed  Google Scholar 

  44. Clayton PE, Gill MS, Hall CM, Tillmann V, Whatmore AJ, Price DA . Serum leptin through childhood and adolescence Clin Endocrinol (Oxf) 1997 46: 727–733.

    CAS  Article  Google Scholar 

  45. Ellis KJ, Nicolson MY . Leptin levels and body fatness in children: effects of gender, ethnicity, and sexual development Pediatr Res 1997 42: 484–488.

    CAS  Article  Google Scholar 

  46. Blum WF, Englaro P, Hanitsch S, Juul A, Hertel NT, Muller J, Skakkebaek NE, Heiman ML, Birkett M, Attanasio AM, Kiess W, Rascher W . Plasma leptin levels in healthy children and adolescents: dependence on body mass index, body fat mass, gender, pubertal stage, and testosterone J Clin Endocrinol Metab 1997 82: 2904–2910.

    CAS  PubMed  Google Scholar 

  47. Falorni A, Bini V, Molinari D, Papi F, Celi F, Di Stefano G, Berioli MG, Bacosi ML, Contessa G . Leptin serum levels in normal weight and obese children and adolescents: relationship with age, sex, pubertal development, body mass index and insulin Int J Obes Relat Metab Disord 1997 21: 881–890.

    CAS  Article  Google Scholar 

  48. Woods SC, Seeley RJ, Porte D, Schwartz MW . Signals that regular food intake and energy homeostasis Science 1998 280: 1378–1383.

    CAS  Article  Google Scholar 

  49. Rosenbaum M, Nicolson M, Hirsch J, Heymsfield SB, Gallagher D, Chu F, Leibel . Effects of gender, body composition and menopause on plasma concentrations of leptin J Clin Endocrinol Metab 1996 81: 3424–3427.

    CAS  PubMed  Google Scholar 

  50. Collier GR, De Silva A, Sanigorski A, Walder K, Yamamoto A, Zimmet P . Development of obesity and insulin resistance in the Israeli sand rat (Psammomys obesus). Does leptin play a role? Ann N Y Acad Sci 1997 827: 50–63.

    CAS  Article  Google Scholar 

  51. Couillard C, Mauriege P, Prud'homme D, Nadeau A, Tremblay A, Bouchard C, Despres JP . Plasma leptin concentrations: gender differences and associations with metabolic risk factors for cardiovascular disease Diabetologia 1997 40: 1178–1184.

    CAS  Article  Google Scholar 

  52. Chu NF, Spiegelman D, Rifai N, Hotamisligil GS, Rimm EB . Glycemic status and soluble tumor necrosis factor receptor levels in relation to plasma leptin concentrations among normal weigh and overweight US men Int J Obes Relat Metab Disord 2000 24: 1085–1092.

    CAS  Article  Google Scholar 

Download references

Acknowledgements

This study was supported by the Department of Health, Executive Yuan, Taiwan. Dr Chu's work is supported by a Research Award from the National Defense Medical Center, Taiwan. The authors acknowledge Dr Gerald S Berenson for his valuable guidance and comments on the early proposal and conduction of this study.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to N-F Chu.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Chu, NF., Wang, DJ., Shieh, SM. et al. Plasma leptin concentrations and obesity in relation to insulin resistance syndrome components among school children in Taiwan—The Taipei Children Heart Study. Int J Obes 24, 1265–1271 (2000). https://doi.org/10.1038/sj.ijo.0801404

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0801404

Keywords

  • leptin
  • obesity
  • insulin resistance syndrome
  • children

This article is cited by

Search

Quick links