High free leptin index as the risk factor for childhood obesity in Indonesia: A case-control study

Identifying the risk factors is critical in preventing childhood obesity. Leptin concentration is elevated in obesity. High serum leptin levels are believed to reduce soluble leptin receptor (sOB-R) concentrations and are associated with leptin resistance. The free leptin index (FLI) is a biomarker of leptin resistance and the status of leptin action. This study aims to investigate the association between leptin, sOB-R, and FLI with measurements to diagnose obesity in children, such as BMI, waist circumference and waist-to-height ratio (WHtR). We conducted a case-control study in 10 elementary schools in Medan, Indonesia. The case group was children with obesity, while the control group was children with normal BMI. Leptin and sOB-R levels were measured from all the subjects using the ELISA method. Logistic regression analysis was employed to determine which factors were predictor variables of obesity. A total of 202 children between 6 and 12 years old were recruited for this study. Children with obesity showed significantly higher leptin levels and FLI and lower SOB-R levels FLI (p < .05) than control. The cut-off for WHtR in this study was 0.499 (sensitivity 90% and specificity 92.5%). Children with higher leptin levels had a higher risk of obesity based on BMI, waist circumference, and WHtR values.