leptin and Cerebral-Palsy

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.

Topics: Biomarkers; Body Height; Body Weight; Cerebral Palsy; Child; Demography; Female; Humans; Leptin; Male; ROC Curve; Skinfold Thickness

This study was undertaken to describe anthropometry, body composition parameters and assess serum levels of leptin and other biochemical markers of the nutritional status in a sample of Egyptian children with cerebral palsy(CP).. Anthropometric measurements (body weight, knee height, head, mid-upper arm, waist and hip circumferences, triceps and subscapular skin-fold thickness) were taken. Using the bioelectrical impedance technique, total body water(TBW), fat-free mass, fat mass, fat percentage and basal metabolic rate(BMR) were calculated. Serum levels of total proteins, albumin, ferritin and leptin were measured. Results were compared to that of healthy controls.. Patients had significantly lower anthropometric measurements than controls, except for mid-upper arm and hip circumferences, and subscapular skin-fold thickness which were not different in both groups. Fat mass, fat free mass, fat percentage, TBW and BMR were lower in the patients. Serum protein and leptin levels were not different in patients and controls, though other biochemical markers were reduced in the patients. Patients with more severe motor handicap had lower skin-fold thickness, fat percentage and serum ferritin than those with milder affection.. Parameters of growth, body composition analysis and nutritional status are significantly altered in CP patients especially those with severe motor handicap and oromotor dysfunction.

Topics: Anthropometry; Basal Metabolism; Biomarkers; Body Composition; Body Size; Body Water; Cerebral Palsy; Child; Child Development; Child, Preschool; Cross-Sectional Studies; Egypt; Electric Impedance; Female; Ferritins; Hospitals, Pediatric; Humans; Leptin; Male; Nutritional Status; Severity of Illness Index

Children with Cerebral Palsy (CP) are generally undernourished and growth retarded than normal children. The reasons of malnutrition are not only due to poor nutritional status but also nonnutritional factors including negative neurotrophic effects and indirect factor such as immobility, endocrinological abnormalities or spasticity that energy requirements might be contributing factors. Several studies indicated that leptin which is produced by adipocytes, might regulate energy intake and expenditure. The aim of this study is to determine serum leptin levels in children with CP and to investigate the relationship between nutritional status and anthropometric measurements.. Forty children with CP and 18 healthy controls were included in this study. The weight, height, body mass index (BMI), upper arm length (UAL) and triceps skinfold thickness (TST) was measured in all children. Serum leptin, growth hormone, C-peptide and cortisol levels were studied. Based on TST measurement CP patients were divided as DSF group (decreased subcutaneous fat) and non-DSF group (nondecreased subcutaneous fat).. UAL were shorter and TST measurements were thinner than control group (p<0.05, p<0.01). Group DSF had lower leptin concentrations compared to Group non-DSF and controls (p<0.001, p<0.001). On the other hand non DSF group had higher leptin levels than controls (p<0.05). There was a positive and significant correlation between leptin and anthropometric measurements, especially TST in children with CP. Serum leptin levels were also lower in non-ambulatory children than ambulatory children with CP (p<0.05).. This study has shown that triceps skinfold thickness is better index for the evaluation of nutritional status in children with CP. Serum leptin levels were lower in CP, especially in DSF group. The possible explanation of this finding may not only related with malnutrition, but also immobility related other factors such as bone metabolism and spasticity. We concluded that leptin which regulates energy intake might have a role of nutritional disorders in cerebral palsy. To better understand this relationship further studies are needed.

Topics: Adolescent; Anthropometry; C-Peptide; Cerebral Palsy; Child; Child Nutrition Disorders; Child, Preschool; Energy Metabolism; Female; Growth Disorders; Human Growth Hormone; Humans; Hydrocortisone; Leptin; Male; Nutritional Status