Serum Leptin Levels in Childhood Celiac Disease

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Abstract
Objective Leptin has effects on growth and is also involved in immune regulation. We thought that with its intestinal histopathologic alterations due to immune mechanisms, and subsequent malnutrition and/or growth failure, celiac disease (CD) deserves interest regarding leptin status. Method Serum leptin levels of 19 children with CD on admission and 1 year after gluten-free diet (GFD) and of 16 healthy children were determined. Results Mean age was 9.7±3.3 years. Mean serum leptin level of children with CD on admission and of healthy children were 1.60±0.63 ng/mL, and 3.98±1.49 ng/mL, respectively (P: 0.0001). Mean serum leptin level under GFD was 4.55±1.97 ng/mL. There was a statistical significant difference between serum levels determined before and 1 year after GFD (P: 0.001) and between those of under GFD and healthy children (P: 0.001). Of 19 patients with CD, 10 (52.6%) showed Marsh IIIc, other 9 (47.4%) showed Marsh IIIa histologic lesions. Mean serum leptin level of children with Marsh IIIc and Marsh IIIa were not different (1.70±0.73 ng/mL vs. 1.45±0.59 ng/mL). Leptin was correlated with body mass index in healthy children, and in CD both before and after GFD (P<0.001). Mean lumbar z score of the patients on admission and after GFD were 2.7±1.3 and 1.9±0.8, respectively (P: 0.048). Serum leptin level was not correlated with lumbar z score either before or after GFD. Conclusions Serum leptin level is affected in childhood CD, it is not directly related to histopathologic findings, and is responsive to GFD. Further studies investigating its level in different clinical and histopathologic presentations might give clear clues about the role of leptin in CD.