Tohoku J. Exp. Med., 2016 June, 239(2)

Serum Leptin as a Nutritional Biomarker in Children with Cerebral Palsy

CHAVARIN AMARASE,¹ SOARAWIT WEERASOPONE,¹ PHATCHARAPA OSATEERAKUN,² SITTISAK HONSAWEK^1,3 and NOPPACHART LIMPAPHAYOM¹

¹Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
²Department of Orthopaedics, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
³Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

Adequate nutrition is crucial for children with cerebral palsy (CCP). However, conventional nutritional assessments may be inadequate for defining undernourished CCP. Leptin, an adipocyte hormone controlling energy expenditure, could be a useful marker. Objectives of this cross-sectional analytic study were to explore correlations between serum leptin level and nutritional status, anthropometric measurements, and biochemical parameters in 86 CCP (aged 9 ± 2 years). Subscapular (SST) and triceps (TST) skinfold thicknesses, weight, and calculated height were obtained. Body mass index and weight-for-height (WH) Z-scores were calculated. Complete blood count and serum levels of leptin and albumin were collected. CCP were classified as undernourished if their WHZ was < −2 according to the World Health Organization criteria. Correlations between anthropometric measurements, biochemical data, and serum leptin levels were evaluated. From 86 CCP, 11 (12%) children were undernourished, and SST, hemoglobin, and hematocrit were significantly lower. Serum leptin levels of nourished and undernourished CCP were 5.4 ± 6.2 and 2.9 ± 1.6 ng/mL (p < 0.001), while the reported value from normal children was 4.9 ng/mL. Serum leptin levels demonstrated a significant correlation with SST and TST (r = 0.83 and 0.72; p < 0.001). Serum leptin was the only marker significantly correlated with WHZ (r = 0.45, p < 0.001) while adjusting for covariates. A serum leptin level of 2.2 ng/mL was the optimal cutoff point for defining adequate nutritional status (WHZ ≥ −2). The measurement of serum leptin should be included in a care scheme of CCP especially during surgical evaluation.

keywords —— anthropometry; cerebral palsy; leptin; nutritional status; preoperative care

© 2016 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2016, 239, 139-146

Correspondence: Noppachart Limpaphayom, M.D., Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 road, Pathumwan, Bangkok 10330, Thailand.

e-mail: noppachart.l@chula.ac.th