Sex Differences in Leptin Levels in Children and Adolescents with Normal Weight and Overweight/Obesity Across Pubertal Stages: A Systematic Review and Meta-analysis - Scorecard - MDSpire
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Sex Differences in Leptin Levels in Children and Adolescents with Normal Weight and Overweight/Obesity Across Pubertal Stages: A Systematic Review and Meta-analysis
Clinical Scorecard: Sex-Based Variations in Leptin Concentrations Among Normal Weight and Overweight/Obese Children and Adolescents Throughout Puberty: A Comprehensive Review and Meta-Analysis
At a Glance
Category
Detail
Condition
Leptin level variations and their relationship with puberty and obesity in children and adolescents
Key Mechanisms
Leptin produced by adipose tissue regulates energy homeostasis and acts as a permissive factor for puberty onset via stimulation of the hypothalamus-pituitary-gonadal axis, interacting with kisspeptin and other neuropeptides
Target Population
Children and adolescents aged 5 to 19 years with normal weight and overweight/obesity
Care Setting
Pediatric endocrinology and obesity management settings
Key Highlights
Girls with normal weight have consistently higher leptin levels than boys across all pubertal stages.
In overweight/obese children, sex differences in leptin levels are diminished during prepubertal and pubertal stages but reappear postpubertally.
Obesity disrupts the typical sex-specific leptin pattern, suggesting leptin alone does not explain accelerated puberty in obese girls.
Guideline-Based Recommendations
Diagnosis
Assess leptin levels alongside BMI-SDS and pubertal staging (Tanner stages) to evaluate pubertal development and obesity status.
Consider sex-specific differences when interpreting leptin concentrations in pediatric patients.
Management
Monitor body composition and leptin levels in children with overweight/obesity to understand pubertal progression.
Address obesity early to potentially modulate its impact on pubertal timing, especially in girls.
Monitoring & Follow-up
Track pubertal development using Tanner staging and BMI-SDS in conjunction with leptin measurements.
Observe sex-specific hormonal changes, including testosterone and estrogen levels, to contextualize leptin data.
Risks
Obesity-related alterations in leptin and sex steroid levels may contribute to abnormal pubertal timing and metabolic complications.
Low leptin levels (e.g., in congenital deficiency or anorexia nervosa) can cause hypogonadotropic hypogonadism and delayed puberty.
Patient & Prescribing Data
Children and adolescents aged 5-19 years with normal weight or overweight/obesity undergoing pubertal development
Leptin levels reflect nutritional status and adiposity but are insufficient alone to explain sex differences in pubertal timing; combined evaluation with other neuroendocrine factors is recommended.
Clinical Best Practices
Use sex- and age-specific BMI percentiles and BMI-SDS for accurate classification of overweight and obesity in pediatric patients.
Incorporate leptin measurement as part of a comprehensive assessment of pubertal development and metabolic status.
Recognize that obesity may mask typical sex differences in leptin levels during puberty, necessitating multifactorial evaluation.
Consider the role of kisspeptin and other neuroendocrine regulators alongside leptin in managing pubertal disorders.
Educate families about the impact of obesity on puberty and metabolic health to encourage early lifestyle interventions.
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