Can leptin-specific epigenetic modulation of preterm cord blood predispose obesity?
Authors: Boga Navya Sree , Banerjee Amit K , Varma Saikanth , Molangiri Archana , Farhana Syeda , Banjara Santosh Kumar , Bagga Nitasha , Duttaroy Asim K. , Basak Sanjay 
Published: December 2024

AbstractObjectiveThis retrospective cohort investigated the role of leptin’s promoter methylation and microRNA targeting profile in developing adiposity and inflammation in neonates, using umbilical cord blood from preterm (n=67) and term (n=71) mothers.MethodsGlobal DNA methylation and leptin promoter methylation were performed. ELISA determined leptin and IGF1 levels. Real-time PCR measured mRNA levels. MicroRNA target prediction on the human leptin gene (LEP) was donein silicousing network analysis.ResultsPreterm cord blood significantly reduced genome-wide (p<0.001) andLEPpromoter methylation (p=0.001), increasedLEP&LEPRexpression (p=0.04), and circulatory leptin (p=0.41). Neonatal birth weight positively correlated with leptin and IGF1 levels in preterm (r=0.47, p=0.04) but not in the term.IL6expression showed a positive correlation with circulatory leptin (r= 0.687, p=0.008),LEP(r= 0.763, p=0.009), and an inverse association withLEPpromoter methylation (r= -0.636, p=0.04) in preterm. The obtainedLEPtargeting miRNAs showed their affinities for critical genes associated with body fat distribution, fat cell differentiation, and energy regulation, implicating a close association in theLEP-miRNA-obesity axis.ConclusionsThe strong correlation betweenLEPmethylation and pro-inflammatory cytokine influences each other in developing chronic inflammation in preterm neonates, which might predispose them to obesity in later life.Study importanceWhat is already known?Leptin communicates about the body’s fat deposits to the brain and aids in maintaining energy homeostasis and stable body weight.Preterm exhibit lower body weight and fat mass at birth than term neonates, who often show rapid compensatory catch-up growth.What does this study add?Leptin gene (LEP) promoter methylation was reduced in preterm cord blood compared to term.Higher interleukin-6 (IL6) and tumour necrosis factor-alpha (TNFα)expression in preterm but not in term.IL6correlated positively with circulatory leptin andLEPexpression while inversely associated withLEP-specific promoter methylation, indicating that a dysregulated epigenetic control can promote low-grade inflammation in preterm neonates.LEP-targeting micro-RNAs showed affinities for critical genes associated with fat cell differentiation, energy regulation, and other processes.How might these results change the direction of research or the focus of clinical practice?Since others observed dysregulatedLEPmethylation in the adipose tissue of obese subjects, these data imply that leptin could mediate the risk for obesity during preterm birth.While short-term outcomes of preterm birth are well addressed, its effect on long-term metabolic health is of concern as it might elevate the risk of obesity.Graphical AbstractMaternal factors leading to preterm birth and cord blood leptin dysregulation in predicting obesity. Elevated blood pressure, infection, and lower haemoglobin in preterm disrupted epigenetic control of leptin and activated inflammation that might induce leptin resistance. The latter is known to reduce satiety and increase body mass, elevating the risk of obesity. Solid arrows depict present data, and dotted lines indicate possible pathways.