Predictive Value of the Adiponectin-to-Leptin Ratio for Insulin Resistance and Cardiometabolic Risk in Obese Children and Adolescents aged 10–18 years
Keywords:
Adiponectin, Leptin, Adiponectin-to-leptin ratio, Insulin resistance, Childhood obesityAbstract
Childhood obesity is increasingly associated with early cardiometabolic problems and insulin resistance. The adipokine ratio may be a better indicator of metabolic dysfunction than either adipokine alone since both leptin and adiponectin are hormone agents that are generated by fat and have distinct metabolic activities. This research sought to determine if the adiponectin-to-leptin ratio (ALR) might predict insulin resistance and cardiometabolic risk in obese children and adolescents. This descriptive cross-sectional analytical research was conducted at Tikrit Teaching Hospital between February 2024 and February 2025. Fifty kids of comparable age and gender and fifteen obese kids and teenagers (10–18 years old). Following an overnight fast, anthropometric and clinical parameters were assessed, and blood samples were taken to evaluate glucose, insulin, adiponectin, leptin, lipid profile, and high sensitivity C-reactive protein. The HOMA-IR was used to measure insulin resistance, and the ratio of serum adiponectin to leptin was used to measure ALR. Receiver operating characteristic analysis, multivariable regression analysis, and correlation analysis were performed. Adiponectin and ALR values were substantially lower in the obese individuals compared to the control group (P < 0.001), whereas BMI, WC, fasting insulin levels, HOMA-IR, leptin, triglycerides, LDL-C, blood pressure, and hs-CRP values were significantly higher. ALR was an independent predictor of insulin resistance and had a negative correlation with HOMA-IR (r = −0.61, P < 0.001). With an AUC of 0.86, a sensitivity of 82.0%, a specificity of 78.7%, and an ideal cut-off of ≤0.28, ALR was shown to be the greatest predictor of insulin resistance based on ROC analysis. Additionally, ALR predicted significant cardiometabolic risk with a high AUC of 0.82. In obese children and adolescents, the adiponectin-to-leptin ratio has a substantial correlation with insulin resistance and cardiometabolic disorders. It may be a valuable biomarker for identifying children who are at increased metabolic risk.
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[10] World Health Organization, “Growth reference data for 5–19 years,” 2007. [Online]. Available: [https://www.who.int/tools/growth-reference-data-for-5to19-years](https://www.who.int/tools/growth-reference-data-for-5to19-years). [Accessed: Sep. 17, 2026].
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