Journal of Endocrinological Investigation

, Volume 37, Issue 2, pp 119–126 | Cite as

Pre-treatment circulating leptin/ghrelin ratio as a non-invasive marker to identify patients likely to regain the lost weight after an energy restriction treatment

  • A. B. CrujeirasEmail author
  • A. Díaz-Lagares
  • I. Abete
  • E. Goyenechea
  • M. Amil
  • J. A. Martínez
  • F. F. Casanueva
Original Article



Leptin and ghrelin appear to play a role in weight regain after a successful weight loss. The pre-treatment plasma levels of leptin/ghrelin ratio (L/G) could have power to predict this clinically relevant issue in the obesity treatment.


To evaluate the ability of the L/G as a non-invasive tool for the early discrimination of obese patients who are more likely to regain weight after an energy restriction program (regainers) from those who maintain the lost weight (non-regainers).

Subjects and methods

Fasting leptin and ghrelin levels were evaluated in 88 overweight/obese patients who followed an 8-week hypocaloric diet program and were categorized as regainers (≥10 % weight-lost regain) and non-regainers (<10 % weight-lost regain) 6 months (32 weeks) after finishing the dietary treatment. A receiver operating characteristic (ROC) curve analysis was employed to evaluate the diagnostic value of the L/G ratio and to establish a cut-off point to differentiate regainers from non-regainers.


Regainers showed a statistically higher baseline (week 0) and after treatment (week 8) L/G ratio than non-regainers. The baseline L/G ratio was associated with an increased risk for weight regain (odds ratio 1.051; p = 0.008). Using the area under the ROC curve (AUC), the L/G ratio significantly identified female (AUC = 0.69; p = 0.040) and male regainers (AUC = 0.68; p = 0.030). The maximum combination of sensitivity and specificity was shown at the cut-off point of 26.0 for women and 9.5 for men.


The pre-intervention fasting leptin/ghrelin ratio could be a useful non-invasive approach to personalize obesity therapy and avoid unsuccessful treatment outcomes.


Hypocaloric diet Diagnostic biomarkers Obesity Weight maintenance Weight regain 



The authors are grateful to the volunteers of the study. They also wish to thank their physician Blanca E Martínez de Morentin, their nurse Salomé Pérez, their dietician María Hernandez and their technicians Verónica Ciaurriz and Ana Lorente for excellent clinical and technical assistance, respectively. They received no additional compensation for this contribution. This work was supported by Linea Especial about Nutrition, Obesity and Health (University of Navarra LE/97), CIBERobn and RETICS/PREDIMED, ISCIII Initiatives. AB Crujeiras, is funded by the ISCIII through a postdoctoral research contract “Sara Borrell” (CD09/00365). A Díaz-Lagares was supported by the Angeles Alvariño-2009 postdoctoral fellowship from the Xunta de Galicia and European Social Fund (ESF) and at present is the recipient of a “Sara Borrell” postdoctoral contract (CD12/00738) from the ISCIII at the Spanish Ministry of Economy and Competitiveness.

Conflict of interest

The authors A. B. Crujeiras, A. Díaz-Lagares, I. Abete, E. Goyenechea, M. Amil, J. A. Martínez, and F. F. Casanueva declare that they have no conflict of interest.


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Copyright information

© Italian Society of Endocrinology (SIE) 2013

Authors and Affiliations

  • A. B. Crujeiras
    • 1
    • 4
    Email author
  • A. Díaz-Lagares
    • 2
  • I. Abete
    • 3
    • 4
  • E. Goyenechea
    • 3
    • 4
  • M. Amil
    • 1
    • 4
  • J. A. Martínez
    • 3
    • 4
  • F. F. Casanueva
    • 1
    • 4
  1. 1.Laboratory of Molecular and Cellular Endocrinology, Instituto de Investigación SanitariaComplejo Hospitalario Universitario de Santiago (CHUS) and Santiago de Compostela University (USC)Santiago de CompostelaSpain
  2. 2.Fundacion Publica Galega de Medicina XenomicaSantiago de CompostelaSpain
  3. 3.Department of Nutrition, Food Science and PhysiologyUniversity of Navarra (UNAV)PamplonaSpain
  4. 4.CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERobn)MadridSpain

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