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Meta-Analysis
. 2021 Sep 24;13(10):3350.
doi: 10.3390/nu13103350.

Leptin as a Biomarker of Stress: A Systematic Review and Meta-Analysis

Jean-Baptiste Bouillon-Minois  1   2 , Marion Trousselard  3 , David Thivel  4 , Amanda C Benson  5 , Jeannot Schmidt  1   2 , Farès Moustafa  2 , Damien Bouvier  6   7 , Frédéric Dutheil  1   8
Affiliations
Meta-Analysis

Leptin as a Biomarker of Stress: A Systematic Review and Meta-Analysis

Jean-Baptiste Bouillon-Minois et al. Nutrients. .

Abstract

Background: Leptin is a satiety hormone mainly produced by white adipose tissue. Decreasing levels have been described following acute stress.

Objective: To conduct a systematic review and meta-analysis to determine if leptin can be a biomarker of stress, with levels decreasing following acute stress.

Methods: PubMed, Cochrane Library, Embase, and ScienceDirect were searched to obtain all articles studying leptin levels after acute stress on 15 February 2021. We included articles reporting leptin levels before and after acute stress (physical or psychological) and conducted random effects meta-analysis (DerSimonian and Laird approach). We conducted Meta-regressions and sensitivity analyses after exclusion of groups outside the metafunnel.

Results: We included seven articles-four cohort and three case-control studies-(28 groups) from 27,983 putative articles. Leptin levels decreased after the stress intervention (effect size = -0.34, 95%CI -0.66 to -0.02) compared with baseline levels, with a greater decrease after 60 min compared to mean decrease (-0.45, -0.89 to -0.01) and in normal weight compared to overweight individuals (-0.79, -1.38 to -0.21). There was no difference in the overweight population. Sensitivity analyses demonstrated similar results. Levels of leptin after stress decreased with sex ratio-i.e., number of men/women-(-0.924, 95%CI -1.58 to -0.27) and increased with the baseline levels of leptin (0.039, 0.01 to 0.07).

Conclusions: Leptin is a biomarker of stress, with a decrease following acute stress. Normal-weight individuals and women also have a higher variation of leptin levels after stress, suggesting that leptin may have implications in obesity development in response to stress in a sex-dependent manner.

Keywords: anxiety; appetite; mental health; metabolism; public health.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Meta-analysis of leptin levels after an acute stress compared to baseline levels after exclusion of studies outside of the metafunnel.
Figure 1
Figure 1
Search strategy.
Figure 2
Figure 2
Methodological quality of included articles using Newcastle—Ottawa Quality Assessment Scale Yes, +; No, −; Cannot say, ?; Not applicable, N/A; 0, percentage of non-response.
Figure 3
Figure 3
Meta-analysis of leptin levels following acute stress compared to baseline. SMD, standardized mean difference.
Figure 4
Figure 4
Meta-analysis of leptin levels following acute stress compared to baseline levels, stratified by weight of individuals. SMD, standardized mean difference.
Figure 5
Figure 5
Meta-analysis of leptin levels after acute stress compared to baseline levels after exclusion of studies outside of the metafunnel. SMD, standardized mean difference.
Figure 6
Figure 6
Meta-regression.
See this image and copyright information in PMC

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