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Summary   Objective  This study aims to investigate relations of serum leptin at age 4 with development of adiposity and linear growth during 3 years of follow‐up among 75 Greek children and to identify serum metabolites associated with leptin at age 4 and to characterize their associations with adiposity gain and linear growth.    Methods  Linear regression models that accounted for maternal age, education and gestational weight gain and child's age and sex were used to examine associations of leptin and leptin‐associated metabolites measured at age 4 with indicators of adiposity and linear growth at age 7.    Results  Each 1‐unit increment in natural log‐(ln)‐transformed leptin corresponded with 0.33 (95% CI: 0.10, 0.55) units greater body mass index‐for‐age z‐score gain during follow‐up. Likewise, higher levels of the leptin‐associated metabolites methylmalonyl‐carnitine and glutaconyl‐carnitine corresponded with 0.14 (95% CI: 0.01, 0.27) and 0.07 (95% CI: −0.01, 0.16) units higher body mass index‐for‐age z‐score gain, respectively. These relationships did not differ by sex or baseline weight status and were independent of linear growth.    Conclusions  These findings suggest that leptin, methylmalonyl‐carnitine and possibly glutaconyl‐carnitine are associated with weight gain during early childhood. Future studies are warranted to confirm these findings in other populations.

Leptin, acylcarnitine metabolites and development of adiposity in the Rhea mother–child cohort in Crete, Greece