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Licensed Unlicensed Requires Authentication Published by De Gruyter March 7, 2019

Adiposity and adipocytokines: the moderator role of cardiorespiratory fitness and pubertal stage in girls

  • Caroline Brand EMAIL logo , Neiva Leite , Wendell Arthur Lopes , Arieli Fernandes Dias , Larissa Rosa da Silva , Adroaldo Cezar Araujo Gaya , Jorge Mota , Claudia Regina Cavaglieri and Anelise Reis Gaya



Cardiorespiratory fitness (CRF) and pubertal stages have been related to many health outcomes, including obesity and adipocytokines. Thus, the present study aimed to analyze the moderator role of CRF and pubertal stage in the relationship between adiposity and adipocytokines in girls.


This cross-sectional study was performed with 42 pre-pubertal girls aged from 7 to 11 years and 54 post-pubertal girls aged from 13 to 17 years. Blood samples were collected to determine the serum levels of leptin and adiponectin, and then the leptin/adiponectin ratio (L/A ratio) was calculated. CRF, anthropometric and body composition indicators were assessed. For statistical analysis, descriptive statistics and several linear regression models were used. The moderation analysis was tested using the PROCESS macro.


An interaction between body mass index (BMI) and CRF (β: –0.70; confidence interval [CI]: –1.29, –0.12), as well as between BMI and pubertal stage (β: 0.79; CI: 0.28, 1.30) with leptin, was found. Regarding the L/A ratio, an interaction was found only in BMI × CRF (β: –0.56; CI: –1.06, –0.06). Using a combined interaction (CRF and pubertal stage), the results showed a positive association between BMI with leptin and L/A ratio only in low CRF, pre-pubertal and post-pubertal stages.


This study suggests a protective role of high levels of CRF in the relationship between BMI and adipocytokines. Despite the effect of pubertal stage, the results suggest that youth should be engaged in physical activity in order to improve CRF levels and consequently improve cardiometabolic health.


The authors acknowledge the research fellowship from the National Council for Scientific and Technological Development (CNPq) Brazil and The scholarships from the Coordination of Improvement of Higher Education Personnel (CAPES) Brazil. Foundation for Science and Technology (FCT), Portugal: SFRH/BSAB/142983/2018 and UID/DTP/00617/2019 as well as Santander University Scholarship Program 2018.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: National Council for Scientific and Technological Development, process number 401969/2016-9/, Funder Id: 10.13039/501100003593 Universal Announcement.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. 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.


1. Wijnhoven TM, Van Raaij JM, Spinelli A, Starc G, Hassapidou M, et al. WHO European childhood obesity surveillance initiative: body mass index and level of overweight among 6−9-year-old children from school year 2007/2008 to school year 2009/2010. BMC Public Health 2014;14:806.10.1186/1471-2458-14-806Search in Google Scholar PubMed PubMed Central

2. Ogden CL, Carrol MD, Kit BK, Flegal KM. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999−2010. J Am Med Assoc 2012;307:483.10.1001/jama.2012.40Search in Google Scholar PubMed PubMed Central

3. Ighbariya A, Weiss R. Insulin resistance, prediabetes, metabolic syndrome: what should every pediatrician know? J Clin Res Pediatr Endocrinol 2017;9:49−57.10.4274/jcrpe.2017.S005Search in Google Scholar PubMed PubMed Central

4. Romacho T, Elsen M, Röhrborn D, Eckel J. Adipose tissue and its role in organ crosstalk. Acta Physiol 2014;210:733–53.10.1111/apha.12246Search in Google Scholar PubMed

5. Trayhurn P, Wood IS. Adipokines: inflammation and the pleiotropic role of white adipose tissue. Br J Nutr 2004;92:347–55.10.1079/BJN20041213Search in Google Scholar

6. Yadav A, Kataria MA, Saini V, Yadav A. Role of leptin and adiponectin in insulin resistance. Clin Chim Acta 2013;417:80–4.10.1016/j.cca.2012.12.007Search in Google Scholar PubMed

7. Allison MB, Myers MG. Connecting leptin signaling to biological function. J Endocrinol 2014;223:25–35.10.1530/JOE-14-0404Search in Google Scholar PubMed PubMed Central

8. Ghadge AA, Khaire AA, Kuvalekar AA. Adiponectin: a potential therapeutic target for metabolic syndrome. Cytokine Growth Factor Rev 2018;39:151–8.10.1016/j.cytogfr.2018.01.004Search in Google Scholar PubMed

9. Ouchi N, Parker JL, Lugus JJ, Walsh K. Adipokines in inflammation and metabolic disease. Nat Rev Immunol 2011;11:85–97.10.1038/nri2921Search in Google Scholar PubMed PubMed Central

10. López-Jaramillo P, Gómez-Arbeláez D, López-López J, López-López C, Martínez-Ortega J, et al. The role of leptin/adiponectin ratio in metabolic syndrome and diabetes. Horm Mol Biol Clin Invest 2014;18:37–45.10.1515/hmbci-2013-0053Search in Google Scholar PubMed

11. Lavie CJ, McAuley PA, Church TS, Milani RV, Blair SN. Obesity and cardiovascular diseases: implications regarding fitness, fatness, and severity in the obesity paradox. J Am Coll Cardiol 2014;63:1345–54.10.1016/j.jacc.2014.01.022Search in Google Scholar PubMed

12. Artero EG, Ruiz JR, Ortega FB, España-Romero V, Vicente-Rodríguez G, et al. Muscular and cardiorespiratory fitness are independently associated with metabolic risk in adolescents: the HELENA study. Pediatr Diabetes 2011;12:704–12.10.1111/j.1399-5448.2011.00769.xSearch in Google Scholar PubMed

13. Ortega FB, Ruiz JR, Castillo MJ, Sjostrom M. Physical fitness in childhood and adolescence: a powerful marker of health. Int J Obes 2008;32:1–11.10.1038/sj.ijo.0803774Search in Google Scholar PubMed

14. Steene-Johannessen J, Kolle E, Andersen LB, Anderssen SA. Adiposity, aerobic fitness, muscle fitness, and markers of inflammation in children. Med Sci Sports Exerc 2013;45:714–21.10.1249/MSS.0b013e318279707aSearch in Google Scholar PubMed

15. Oliveira-Santos J, Santos R, Moreira C, Abreu S, Lopes L, et al. Ability of measures of adiposity in identifying adverse levels of inflammatory and metabolic markers in adolescents. Child Obes 2016;12:135–43.10.1089/chi.2015.0124Search in Google Scholar PubMed

16. Zhu HJ, Li SJ, Pan H, Li N, Zhang DX, et al. The changes of serum leptin and kisspeptin levels in chinese children and adolescents in different pubertal stages. Int J Endocrinol 2016;2016:6790794.10.1155/2016/6790794Search in Google Scholar PubMed PubMed Central

17. Böttner A, Kratzsch J, Müller G, Kapellen TM, Blüher S, et al. Gender differences of adiponectin levels develop during the progression of puberty and are related to serum androgen levels. J Clin Endocrinol Metab 2004;89:4053–61.10.1210/jc.2004-0303Search in Google Scholar PubMed

18. Agostinis-Sobrinho C, Santos R, Moreira C, Abreu S, Lopes L, et al. Association between serum adiponectin levels and muscular fitness in Portuguese adolescents: LabMed Physical Activity Study. Nutr Metab Cardiovasc Dis 2016;26:517–24.10.1016/j.numecd.2016.02.011Search in Google Scholar PubMed

19. Gaya A, Lemos A, Gaya A, Teixeira D, Pinheiro E, et al. PROESP-Br Projeto Esporte Brasil Manual de testes e avaliação 2016;1–20.Search in Google Scholar

20. Lopes WA, Leite N, Rosa L, Trevisan D, Gáspari AF, et al. Effects of 12 weeks of combined training without caloric restriction on inflammatory markers in overweight girls. J Sports Sci 2016;34:1902–12.10.1080/02640414.2016.1142107Search in Google Scholar PubMed

21. Leite N, Rosa L, Jesus ÍC De, Lopes WA, Cavaglieri CR, et al. ADRB2 Gln27Glu polymorphism influenced changes in leptin but not body composition or metabolic and other inflammatory parameters after twelve weeks of combined training in overweight adolescents. Motriz 2017;23:1–13.10.1590/s1980-6574201700si0017Search in Google Scholar

22. Mirwald RL, Baxter-Jones AD, Bailey D, Beunen GP. An assessment of maturity from anthropometric measurements. Med Sci Sports Exerc 2002;34:689–94.10.1249/00005768-200204000-00020Search in Google Scholar

23. Tanner JM. Normal growth and techniques of growth assessment. Clin Endocrinol Metab 1986;15:411–51.10.1016/S0300-595X(86)80005-6Search in Google Scholar

24. Conde WL, Monteiro CA. Body mass index cutoff points for evaluation of nutritional status in Brazilian children and adolescents. J Pediatr 2006;82:26.10.2223/JPED.1502Search in Google Scholar PubMed

25. Agostinis-Sobrinho CA, Lacerda ME, Moreira C, Abreu S, Lopes L, et al. Association between leptin, adiponectin, and leptin/adiponectin ratio with clustered metabolic risk factors in Portuguese adolescents: the LabMed Physical Activity Study. Ann Nutr Metab 2017;70:321–8.10.1159/000477328Search in Google Scholar PubMed

26. Lohman T, Roche A, Martorell F. Anthropometric standardization reference manual. Champaign, IL: Human Kinetics Books, 1991.10.1249/00005768-199208000-00020Search in Google Scholar

27. Bergmann GG. Use of the 6-minute walk/run test to predict peak oxygen uptake in adolescents para a predição do consumo de oxigênio de pico em adolescentes. Rev Bras Atif Fis Saúde 2014;64–73.10.12820/rbafs.v.19n1p64Search in Google Scholar

28. Jones AM, Doust JH. A 1% treadmill grade most accurately reflects the energetic cost of outdoor running. J Sports Sci 1996;14:321–7.10.1080/02640419608727717Search in Google Scholar PubMed

29. Howley ET, Bassett DR Jr, Welch HG. Criteria for maximal oxygen uptake: review and commentary. Med Sci Sports Exerc 1995;27:1292–301.10.1249/00005768-199509000-00009Search in Google Scholar

30. dos Santos FK, Prista A, Gomes TN, Santos D, Damasceno A, et al. Body mass index, cardiorespiratory fitness and cardiometabolic risk factors in youth from Portugal and Mozambique. Int J Obes 2015;39:1–8.10.1038/ijo.2015.110Search in Google Scholar PubMed

31. Grgic J, Dumuid D, Bengoechea EG, Shrestha N, Bauman A, et al. Health outcomes associated with reallocations of time between sleep, sedentary behaviour, and physical activity: A systematic scoping review of isotemporal substitution studies. Int J Behav Nutr Phys Act 2018;15:1–68.10.1186/s12966-018-0691-3Search in Google Scholar PubMed PubMed Central

32. Rutters F, Nieuwenhuizen AG, Verhoef SP, Lemmens SG, Vogels N, et al. The relationship between leptin, gonadotropic hormones, and body composition during puberty in a Dutch children cohort. Eur J Endocrinol 2009;160:973–8.10.1530/EJE-08-0762Search in Google Scholar PubMed

33. Horlick M, Rosenbaum M, Nicolson M, Levine L, Fedun B, et al. Effect of puberty on the relationship between circulating leptin and body composition. J Clin Endocrinol Metab 2000;85:2509–18.Search in Google Scholar

34. Ortega FB, Ruiz JR, Labayen I, Lavie CJ, Blair SN. The Fat but Fit paradox: what we know and don’t know about it. Br J Sports Med 2018;52:151–3.10.1136/bjsports-2016-097400Search in Google Scholar PubMed

35. Borja-Cacho D, Matthews J. Obesity, systemic inflammation, and increased risk for cardiovascular disease and diabetes among adolescents: a need for screening tools to target interventions Mark. Nutrition 2013;29:279–386.Search in Google Scholar

36. Pozuelo-Carrascosa DP, García-Hermoso A, Álvarez-Bueno C, Sánchez-López M, Martinez-Vizcaino V. Effectiveness of school-based physical activity programmes on cardiorespiratory fitness in children: a meta-analysis of randomised controlled trials. Br J Sports Med 2017;52:1234–40.10.1136/bjsports-2017-097600Search in Google Scholar PubMed

Received: 2018-09-22
Accepted: 2018-12-26
Published Online: 2019-03-07
Published in Print: 2019-03-26

©2019 Walter de Gruyter GmbH, Berlin/Boston

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