Abstract
Background
Adolescents having early puberty (EP) are more likely to have obesity and increased cardiometabolic and inflammatory markers and atherosclerosis risk. We aimed to assess the indirect and mediated effects of leptin and adiposity on the relation between EP and cardiometabolic and inflammatory markers in European adolescents.
Methods
A sample of 511 adolescents with EP (12.5–17.5 years) from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) cross-sectional study was studied. To assess whether leptin levels and adiposity mediate the relation between EP and several biomarkers, linear regression models for mediation analyses were performed.
Results
EP was positively associated with the atherogenic index (Ath-I) (β=0.174; 95%CI 0.029–0.265) and negatively associated with the C-reactive protein (CRP) (β=−0.284; 95%CI −0.542 to −0.028) in girls. These associations were fully mediated by leptin levels (9.5%) and adiposity (44%), respectively. Moreover, EP has indirect effects on the apolipoprotein A-1 (ApoA-1) levels through adiposity in girls (for body mass index [BMI], β=0.014; 95%CI 0.005–0.028, and for waist circumference [WC], β=0.011; 95%CI 0.003–0.024), and on ApoA-1 (β=0.012; 95%CI 0.004–0.025), apolipoprotein B (ApoB) (β=−0.004; 95%CI −0.011 to −0.0004) and CRP (β=−0.265; 95%CI −0.819 to −0.047) through abdominal fat in boys.
Conclusions
Leptin levels and adiposity seem to play an important indirect and mediation role in the association between EP and cardiometabolic and inflammatory markers in adolescents. Weight control should be recommended in order to control the impaired cardiometabolic and inflammatory status arising in early pubertal adolescents.
Acknowledgments
We gratefully acknowledge all participating adolescents and their parents for their collaboration. The authors would like to thank Marcus Vinicius Nascimento-Ferreira for the assistance on data interpretation and Rosa María Torres and Anke Carstensen for the laboratory work.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Study has taken place with the financial support of the European Community Sixth RTD Framework Programme (Funder Id: 10.13039/100011103, contract FOOD-CT-2005-007034). This study was also supported by a grant from the Spanish Ministry of Health: Maternal, Child Health and Development Network (number RD08/0072), grant from the Spanish Ministry of Education (EX-2008-0641) and the Swedish Heart-Lung Foundation (20090635). The study is also supported by grants from the Spanish Ministry of Science and Innovation (JCI-2010-07055). The author Tara Rendo-Urteaga was given a post-doctoral scholarship from São Paulo Research Foundation – FAPESP (Funder Id: 10.13039/501100001807, proc. 2014/25233-0). Full Prof. Luis A. Moreno was given a scholarship of visiting professor from São Paulo Research Foundation – FAPESP (Funder Id: 10.13039/501100001807, proc. 2015/11406-3). Augusto César F. de Moraes is in receipt of a post-doctoral scholarship from the National Counsel of Technological and Scientific Development (CNPq: proc. 313772/2014-2) and São Paulo Research Foundation (FAPESP: Funder Id: 10.13039/501100001807, proc. 2014/13367-2 and 2015/14319-4). Heráclito Barbosa Carvalho is in receipt of a Research Grant from São Paulo Research Foundation (FAPESP: Funder Id: 10.13039/501100001807, proc. 2014/11468-6). The GENUD Research Group was co-financed by the European Regional Development Fund (MICINN-FEDER).
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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