Key result
High leptin in metabolically healthy obese youth linked to ~11-fold higher hypertension risk versus normal-weight peers.
Why the study?
Do abnormal adipokine levels increase the risk of incident hypertension in metabolically healthy obese children and adolescents?
Cohort (n=1,184)
Yes
Do abnormal adipokine levels increase the risk of incident hypertension in metabolically healthy obese children and adolescents?
Effect estimate: RR 11.04 (95% CI 1.18-103.35)
Abnormal adipokine levels, specifically high leptin and a high leptin/adiponectin ratio, are associated with a significantly increased risk of incident hypertension in metabolically healthy obese children and adolescents.
High leptin may flag hypertension risk in metabolically healthy obese youth; hypothesis-generating and requires prospective validation.
BACKGROUND: The potential mechanism underlying the relationship between the risk of cardiovascular diseases and metabolically healthy obese (MHO) individuals remains unclear. The aim of the study was to prospectively investigate the potential role of the adipokines in the association between the MHO phenotype and hypertension in children and adolescents. METHODS: A total of 1184 participants at baseline were recruited from a cohort of the Beijing Child and Adolescent Metabolic Syndrome (BCAMS) study. The participants were classified according to their body mass index (BMI) and metabolic syndrome (MS) components. The levels of the adipokines, including leptin, adiponectin, and resistin, were measured. RESULTS: MHO individuals had higher leptin levels (11.58 ug/L vs 1.20 ug/L), leptin/adiponectin ratio (1.18 vs 0.07), and lower adiponectin (11.65 ug/L vs 15.64 ug/L) levels compared to metabolically healthy normal-weight individuals (all P < 0.05). Compared to metabolically healthy normal-weight individuals, the prevalence of high leptin levels (26.5% vs 0.4%), low adiponectin levels (17.9% vs 6.3%) and a high leptin/adiponectin ratio (26.0% vs 2.1%) was higher in MHO individuals (all P < 0.01). The MHO individuals with abnormal adipokines were significantly more likely to developing hypertension (high leptin, relative risk 11.04; 95% confidence interval, 1.18-103.35; and high leptin/adiponectin ratio, relative risk 9.88; 95% confidence interval, 1.11-87.97) compared to metabolically healthy normal-weight individuals with normal adipokine levels. CONCLUSIONS: The abnormal adipokine levels contribute to the increased hypertension risk in MHO children and adolescents. The non-traditional risk factors should be highlighted in MHO children and adolescents in clinical practice and research.
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Ding et al. (2017) conducted a cohort in Metabolically healthy obesity (MHO) (n=1,184). High leptin levels (abnormal adipokines) vs. Normal adipokine levels in metabolically healthy normal-weight individuals was evaluated on Incident hypertension (RR 11.04, 95% CI 1.18-103.35). Metabolically healthy obese children and adolescents with high leptin levels had a significantly increased risk of developing hypertension (RR 11.04) compared to metabolically healthy normal-weight individuals.
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