For citation: Senudin PK, Irwanto, Widjaja NA, Sulistiawati. Metabolic Biomarkers Behind Stunting: The Role of Serum Leptin and Adiponectin in Early Childhood Growth. International Journal of Biomedicine. 2026;16(1):78-82. doi:10.21103/Article16(1)_OA10
Originally published March 5, 2026
Background: Stunting is a nutritional problem that often affects children worldwide. Leptin and adiponectin are essential in modulating bone metabolism and, consequently, skeletal growth and height. This study aims to analyse leptin and adiponectin levels in stunted children and normal children and to determine the threshold values of leptin and adiponectin as early biomarkers of stunting.
Methods and Results: A case-control study was conducted in the working area of Kota Ruteng Primary Health Center Care, in Manggarai Regency, East Nusa Tenggara, Indonesia, from September to December 2024. The subjects were randomly selected from children aged 24-60 months. A total of 80 children, including 38 boys and 42 girls, were enrolled and divided into a stunting group (40 children) and a non-stunting group (40 children).
Multivariate analysis demonstrated that age 2–3 years, premature birth, low birth weight, and height were significant determinants of stunting, while leptin and adiponectin were independently associated with increased risk. ROC analysis showed that leptin had moderate discriminatory ability (AUC = 0.630; cut-off <2.18 ng/mL), whereas adiponectin yielded an AUC of 0.266 with a cut-off <29.5 ng/mL
Conclusion: Stunted children have higher leptin levels, and their height and adiponectin levels are lower than those of non-stunted children. Leptin and adiponectin levels can be used as early biomarkers of stunting.
- Janawisuta H, Gunawan PH. Early Detection of Stunting in Indonesian Toddlers: A Machine Learning Approach. International Conference on Data Science and Its Applications. 2024;12–16. doi :10.1109/ICoDSA62899.2024.10651637
- Montenegro CR, Gomez G, Hincapie O, Dvoretskiy S, DeWitt T, Gracia D, Misas JD. The pediatric global burden of stunting: Focus on Latin America. Lifestyle Medicine. 2022;3(3). doi: 10.1002/lim2.67
- Hafid F, Nasrul N, Amsal A, Ramadhan K, Taufiqurahman T, Sariman S. Low Birth Weight, Child Gender, Number of Children, and Maternal Education as Risk Factors for Stunting in Palu City-Indonesia. Amerta Nutrition.2024;8(2SP):75–84.doi: 10.20473/amnt.v8i2SP.2024.75-84
- Mantzoros CS, Rifas-Shiman SL, Williams CJ, Fargnoli JL, Kelesidis T, Gillman MW. Cord blood leptin and adiponectin as predictors of adiposity in children at 3 years of age: a prospective cohort study. Pediatrics. 2009 Feb;123(2):682-9. doi: 10.1542/peds.2008-0343. PMID: 19171638; PMCID: PMC2761663.
- Aydin HI, Eser A, Kaygusuz I, Yildirim S, Celik T, Gunduz S, Kalman S. Adipokine, adropin and endothelin-1 levels in intrauterine growth restricted neonates and their mothers. J Perinat Med. 2016 Aug 1;44(6):669-76. doi: 10.1515/jpm-2014-0353. PMID: 26352058.
- Park JE, Choi HJ, Kim IK, Lee HJ, Kang JH, Song J. Influence of serum leptin levels on future overweight risk in Korean children. Nutr Metab Cardiovasc Dis. 2012 Mar;22(3):260-8. doi: 10.1016/j.numecd.2010.08.010. Epub 2010 Dec 28. PMID: 21193296.
- Diamond FB Jr, Cuthbertson D, Hanna S, Eichler D. Correlates of adiponectin and the leptin/adiponectin ratio in obese and non-obese children. J Pediatr Endocrinol Metab. 2004 Aug;17(8):1069-75. doi: 10.1515/jpem.2004.17.8.1069. PMID: 15379417.
- Jois A, Navarro P, Ortega-Senovilla H, Gavela-Pérez T, Soriano-Guillén L, Garcés C. Relationship of high leptin levels with an adverse lipid and insulin profile in 6-8 year-old children in Spain. Nutr Metab Cardiovasc Dis. 2015 Dec;25(12):1111-6. doi: 10.1016/j.numecd.2015.09.005. Epub 2015 Sep 25. PMID: 26610652.
- Park S, Vargas Z, Zhao A, Baltazar PI, Friedman JF, McDonald EA. Cord blood adiponectin and leptin are associated with a lower risk of stunting during infancy. Sci Rep. 2022 Sep 6;12(1):15122. doi: 10.1038/s41598-022-19463-3. PMID: 36068284; PMCID: PMC9448758.
- Hossain M, Nahar B, Haque MA, Mondal D, Mahfuz M, Naila NN, Gazi MA, Hasan MM, Haque NMS, Haque R, Arndt MB, Walson JL, Ahmed T. Serum Adipokines, Growth Factors, and Cytokines Are Independently Associated with Stunting in Bangladeshi Children. Nutrients. 2019 Aug 7;11(8):1827. doi: 10.3390/nu11081827. PMID: 31394828; PMCID: PMC6723106.
- Nakano Y. Adult-Onset Diseases in Low Birth Weight Infants: Association with Adipose Tissue Maldevelopment. J Atheroscler Thromb. 2020 May 1;27(5):397-405. doi: 10.5551/jat.RV17039. Epub 2019 Dec 20. PMID: 31866623; PMCID: PMC7242223.
- Anam MS, Mexitalia M, Panunggal B, Sidhartani M, Rachmawati B, Subagio HW. Leptin levels in childhood tuberculosis and its correlation with body mass index, IFN-γ, and TNF-α in an Indonesian population. Indian J Tuberc. 2024 Jan;71(1):35-40. doi: 10.1016/j.ijtb.2023.03.012. Epub 2023 Mar 31. PMID: 38296389.
- Ciptaninggita HD, Theodorean CF, Djais AA, Idrus E, Bachtiar EW. [Analisis Hubungan Antara Kadar Leptin pada Saliva Anak Usia 6-8 Tahun Dengan Status Stunting di NTT]. Univesitas Indonesia; 2022. Available at https://lib.ui.ac.id/detail?id=9999920517468&lokasi=lokal [ Article in Indonesian].
- Surmita S, Megawati G, Fatimah SN, Rakhmawati Y. [Indeks Massa Tubuh dan Massa Lemak serta Kadar Adiponektin Remaja Perawakan Pendek (Body Mass and Fat Mass Indexes and Adiponectin Levels of Stunting Adolescents)]. Indonesia Journal Human Nutrition. 2016 Dec 29; 3(2): 69–74. Doi: 10.21776/ub.ijhn.2016.003.02.2 [ Article in Indonesian].
- Eryando T, Sipahutar T, Budhiharsana MP, Siregar KN, Nur Aidi M, Minarto M, Utari DM, Rahmaniati M, Hendarwan H. Spatial analysis of stunting determinants in 514 Indonesian districts/cities: Implications for intervention and setting of priority. Geospat Health. 2022 May 17;17(1). doi: 10.4081/gh.2022.1055. PMID: 35579253.
- Al Fatiah N, Ari Yuniastuti A, WH N, Lisdiana. Kadar Leptin Balita Stunting yang Diberi Makanan Tambahan Berbasis Daun Kelor dan Ikan Laut. Life Science .2024; 13(1): 35-43.
- Hoffman DJ, Sawaya AL, Verreschi I, Tucker KL, Roberts SB. Why are nutritionally stunted children at increased risk of obesity? Studies of metabolic rate and fat oxidation in shantytown children from São Paulo, Brazil. Am J Clin Nutr. 2000 Sep;72(3):702-7. doi: 10.1093/ajcn/72.3.702. PMID: 10966887.
- Brand C, Gaya ACA, Dias AF, Agostinis-Sobrinho C, Farinha JB, Boeno FP, Mota J, Reischak de Oliveira A, Gaya AR. Relationship between insulin resistance and adipocytokines: the mediator role of adiposity in children. Ann Hum Biol. 2020 May;47(3):244-249. doi: 10.1080/03014460.2020.1740320. Epub 2020 Apr 13. PMID: 32279531.
- Kroll C, Farias DR, Kac G, de França PHC, Mastroeni MF. Adiponectin and leptin gene variants and their effects on body weight trajectories in children from birth to 6 years of age: the PREDI Study. Br J Nutr. 2021 Feb 14;125(3):241-250. doi: 10.1017/S0007114520002780. Epub 2020 Jul 22. PMID: 32693844.
- Mexitalia M, Perdani P, Saputra E, Saputra GI. Cut-Off Levels of Insulin Like Growth Factor-1, Leptin and Adiponectin Umbilical Cord Blood in Low Birth Weight Babies. Medica Hospitalia Journal of Clinical Medicine. 2022;9(3):286–291. doi:10.36408/mhjcm.v9i3.765
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Received December 8, 2025.
Accepted January 24, 2026.
©2026 International Medical Research and Development Corporation.




