Cagla KARAVAIZOGLU, Selda BULBUL
Çocuk Dergisi - 2025;25(4):229-237
Background and Aim: Childhood obesity has become a critical global health issue owing to its immediate and long-term health risks, such as cardiovascular diseases, type II diabetes, and psychosocial challenges. The complex interactions among adipokines, particularly leptin, ghrelin, and adiponectin, play a pivotal role in regulating the energy balance and metabolic processes in obesity. This study aimed to evaluate the levels of leptin, ghrelin, and adiponectin in obese children and adolescents compared with those in a control group and to investigate the relationship between these markers in obese and insulin-resistant (IR+) children. Materials and Methods: A descriptive cross-sectional case-control study was conducted with 172 children and adolescents (112 girls, 60 boys), including 112 obese and 60 controls, aged 6-17 years, who attended the Nutrition and Metabolism Clinic of the Department of Pediatrics at Kırıkkale University. Anthropometric measurements and biochemical parameters, including serum leptin, ghrelin, and adiponectin levels, were obtained. Insulin resistance was defined using the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index, with a cut-off value of > 3.16. Results: There were no significant differences in leptin levels between the obese and control groups (p = 0.161). Ghrelin levels were significantly higher in the obese group (p < 0.001), and adiponectin levels were significantly lower (p < 0.001). Ghrelin and adiponectin levels were also significantly different between the IR+ and control groups (p < 0.001 for both). Insulin resistance was present in 56.5% of the obese children and absent in the controls (p < 0.001). Increased screen time and a positive family history of obesity were significantly more prevalent among obese children (p < 0.001). Conclusion: These findings indicate, but do not conclusively prove, that hormonal imbalances involving ghrelin and adiponectin are associated with pediatric obesity and insulin resistance. The high prevalence of insulin resistance highlights the need for comprehensive lifestyle interventions and targeted therapeutic strategies. Prospective and interventional studies are warranted to confirm these associations and to evaluate effective prevention and management approaches in this population.
