Adipokines and their role in pathogenesis of childhood obesity
Abstract
The review article explores the role of adipokines — bioactive peptides secreted by adipose tissue — in the normal metabolism of the pediatric organism and in childhood obesity. In healthy children, a balance between pro-inflammatory and anti-inflammatory adipokines (leptin, adiponectin, resistin, apelin, omentin, etc.) ensures energy homeostasis, regulation of appetite, insulin sensitivity, immune response, and hormonal development. In pediatric obesity, characteristic shifts in the adipokine profile are observed: hyperleptinemia, hypo-adiponectinemia, and elevated levels of pro-inflammatory adipokines (resistin, visfatin, chemerin, etc.). These changes are closely associated with the development of insulin resistance, chronic low-grade inflammation, non-alcoholic fatty liver disease, and dysfunctions of endocrine axes (early puberty, relative growth hormone deficiency). Adipokines serve not only as markers of metabolic risk but also as promising therapeutic targets. The leptin/adiponectin ratio (L/A) is a reliable predictor of insulin resistance and obesity complications. Interventions — nutritional modification, physical activity, and pharmacotherapy (metformin, GLP-1 agonists, recombinant leptin, etc.) — lead to normalization of the adipokine profile, correlating with clinical improvement. The authors emphasize the importance of early prevention of childhood obesity: breastfeeding, balanced nutrition, and an active lifestyle help maintain a “healthy” adipokine balance and reduce the risk of metabolic and endocrine disorders in the future.
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