Longitudinal analysis of leptin variation during weight regain after weight loss in obese children

Abstract

Objective: This study assessed if lower than predicted serum leptin concentrations seen during weight loss persisted during weight regain, with possible implications for weight control.

Methods: 115 children were investigated during a 12-week weight loss program. 90 children completed the program, and 68 children entered a follow-up program spanning 28 months. Measurements were performed at baseline and day 82 as well as at months 10, 16, and 28. Height, weight, body composition, Tanner stages, testicular size, and serum concentrations of leptin, and insulin were measured at all time points.

Results: Children with the greatest increases in BMI standard deviation score (SDS) exhibited the largest leptin increments. The disproportionate reduction of leptin seen during weight loss recovered after weight loss. Leptin increases mirrored increases in BMI SDS during weight regain, and the leptin-BMI SDS relationship seen during follow-up resembled the baseline leptin-BMI SDS relationship.

Conclusion: Proportional increases of leptin and BMI SDS during weight regain suggests an intact leptin response during re-accumulation of fat. Following the pronounced reduction of leptin during weight loss, leptin levels were restored during weight regain to an extent where leptin levels were comparable with those at baseline, which is indicative of an inefficient lipostatic control exerted by leptin during weight regain.

Fig. 1

Large increases in BMI SDS were accompanied by large relative increases in leptin concentrations during weight regain in a boys and b girls. The relationship between concomitant relative changes in leptin and BMI SDS were significant, and alike between the genders during weight regain. BMI SDS. Regression lines expressing the relationship between leptin and BMI SDS (——) and confidence 2.5 and 97.5% limits (—–) are shown. Regression coefficients and confidence intervals expressing the relationship between leptin concentrations and BMI SDS were 2.3 (95% CI 1.4–3.6) in boys, (p = 0.0006) and 2.6 (95% CI 1.6–4.3) in girls, (p = 0.0016).