J Clin Endocrinol Metab. 2025 Nov 15:dgaf621. doi: 10.1210/clinem/dgaf621. Online ahead of print.
ABSTRACT
CONTEXT: Leptin levels differ significantly between adult men and women, it is unknown whether these sex differences arise during puberty in children with normal weight (NW) or overweight (OW)/obesity (OB).
OBJECTIVE: To analyze sex differences in leptin levels and Body Mass Index Standard Deviation Score (BMI-SDS) across pubertal stages in children with NW and OW/OB.
DATA SOURCES: Eligible studies were obtained from Medline, Embase, Web of science, Cochrane and CINAHL from inception until Feb 2025.
STUDY SELECTION: 24/1713 studies assessing leptin levels in children 5-19 years of age were included.
DATA EXTRACTION: Two reviewers independently extracted data and assessed study quality.
DATA SYNTHESIS: We performed subgroup meta-analysis stratified for pubertal stage using random effects model to estimate the weighted mean difference (WMD) in R. Girls with NW had higher leptin levels than boys at all pubertal stages (pooled MD: 3.99, 95% CI: [2.63, 5.35]). In children with OW/OB, no significant differences were found pre-pubertal and pubertal. At the post-pubertal stage leptin levels were higher in girls compared to boys (MD: 14.60, 95% CI: [0.95, 28.25]), based on one included study. In pubertal children with OW/OB, BMI-SDS was higher in boys than girls (MD: -0.67, 95% CI: [-0.74, -0.61]).
CONCLUSION: The sex-specific differences in leptin levels, characteristic of normal-weight (pre-)pubertal children is lost in obesity. Therefore, leptin levels alone are unlikely to explain why obesity accelerates puberty in girls more than in boys. A combined effect with other factors, such as sex dimorphism in kisspeptin, may play a role.
PMID:41240372 | DOI:10.1210/clinem/dgaf621
