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  • Original Article
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Pediatrics

Association of leptin and insulin with childhood obesity and retinal vessel diameters

International Journal of Obesity volume 38, pages 1241–1247 (2014)Cite this article

Subjects

Abstract

Objective:

Childhood obesity is associated with an impaired retinal microcirculation. The aim of the study was to investigate the association between specific obesity-related biomarkers, physical fitness and retinal vessel diameters in school children.

Design and Subjects:

We studied 381 children aged 10–11 years (body mass index (BMI): 19.3±3.7 kg m−2) in a school-based setting.

Measurements:

Anthropometric measurements and blood sampling were conducted using standard protocols for children. The serum biomarkers leptin, adiponectin, insulin as well as interleukin-6 (IL-6) were analyzed. Physical fitness was determined by a six-item-test battery and physical activity by use of a questionnaire. Central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE) and the arteriolar-to-venular diameter ratio (AVR) were assessed with a non-mydriatic vessel analyzer (SVA-T) using a computer-based program.

Results:

Compared with normal weight children (n=254), obese children (n=39) showed higher leptin (P<0.001), higher insulin (P<0.001), higher IL-6 (P<0.001) and lower adiponectin levels (P=0.013). Obese children demonstrated wider CRVE (P=0.041) and lower AVR (P<0.001). Higher leptin levels were associated with wider CRVE (P=0.032) and lower AVR (P=0.010), that was BMI dependent. Insulin levels were associated with arteriolar (P=0.045) and venular dilatation (P=0.034) after adjustment for BMI. No significant associations between adiponectin levels, IL-6 levels, physical fitness or physical activity and retinal vessel diameter were observed. Lower leptin levels were independently correlated with higher physical fitness (r=−0.33; P<0.001).

Conclusion:

Leptin and insulin levels are associated with changes of the retinal microcirculation. Especially insulin seems to be a good target marker for the cardiometabolic risk assessment in children since elevated insulin levels are independently associated with microvascular end-organ alterations at an early stage. Lifestyle intervention studies are warranted to examine whether improvement of physical fitness or weight reduction can affect cardiometabolic risk markers and reverse alterations of the retinal microcirculation.

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Acknowledgements

We would like to express our gratitude to the children and the staff of the participating schools. We are grateful for the help of the medical technical assistants (MTAs) of the Department of Prevention, Rehabilitation and Sports Medicine of the Technische Universität München, who performed the anthropometric measurements and organized the handling of the blood samples as well as the MTAs of the Department of Internal Medicine II, and the Department of Clinical Chemistry, University of Munich, Grosshadern Campus, who analyzed inflammatory markers. This work has been funded by a grant from the Bavarian State Ministry of the Environment and Public Health (Gesund.Leben.Bayern.) (LP 00001-FA 08).

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Author notes

  1. M Siegrist and H Hanssen: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Klinikum rechts der Isar, Munich, Germany

    M Siegrist, H Hanssen, M Neidig, M Fuchs, F Lechner, M Stetten, K Blume, C Lammel & M Halle

  2. Division of Sports Medicine, Institute of Exercise and Health Sciences, University of Basel, Basel, Switzerland

    H Hanssen

  3. Institute of Medical Statistics and Epidemiology, Technische Universität München, Klinikum rechts der Isar, Munich, Germany

    B Haller

  4. Department of Clinical Chemistry, University of Munich, Grosshadern Campus, Munich, Germany

    M Vogeser

  5. Department of Internal Medicine II, University of Munich, Grosshadern Campus, Munich, Germany

    K G Parhofer

  6. DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany

    M Halle

  7. Else Kröner-Fresenius-Zentrum am Klinikum rechts der Isar, Technische Universität München, Munich, Germany

    M Halle

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Correspondence to M Siegrist.

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Siegrist, M., Hanssen, H., Neidig, M. et al. Association of leptin and insulin with childhood obesity and retinal vessel diameters. Int J Obes 38, 1241–1247 (2014). https://doi.org/10.1038/ijo.2013.226

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