The Relationship Between Serum Adiponectin, Tumor Necrosis Factor-Alpha, Leptin Levels and Insulin Sensitivity in Childhood and Adolescent Obesity: Adiponectin is a Marker of Metabolic Syndrome

Abstract

Objective: This study aimed (a) to investigate the relationship between the degree of obesity and serum adiponectin, tumor necrosis factor (TNF)−α, leptin, insulin levels and the lipid profile; (b) to clarify the relationship between insulin resistance/glucose tolerance and adipocytokine levels; and (c) to investigate the value of adipocytokine levels as a marker of metabolic syndrome (MS).Methods: We studied 151 obese children and adolescents (86 boys and 65 girls; mean age was 12.3±2.4 years). We defined obesity as a body−mass index (BMI) z−score more than 2 SD above the mean for age and sex. The control group consisted of 100 children (48 boys, 52 girls, mean age 12.4±2.5 years). Fasting glucose, insulin levels and lipid profiles were measured in all cases and controls after a 12−hour fast. Adiponectin, TNF−α, and leptin levels were measured in the subjects who participated in the adipocytokine branch of the study. An oral glucose tolerance test (OGTT) was also performed in all obese patients. Obese patients were grouped into three subgroups according to their glucose tolerance and insulin sensitivity assessment, and also according to whether they were grouped as MS or not.Results: Serum levels of total cholesterol, LDL and VLDL cholesterol, log triglyceride, insulin, leptin and TNF−α were higher, whereas HDL and square root adiponectin levels were lower in the obese group when compared with controls. Multiple regression analysis among BMI−z score, LDL, triglyceride, HOMA−IR, leptin and TNF−α as determinants of adiponectin revealed that BMI−z score was the only determinant for adiponectin (r:−0.45, p<0.0001). Adiponectin levels in hyperinsulinemic and impaired glucose tolerance groups (IGT) tended to be lower than in normoinsulinemic obese children, however, the difference was not significant. There was a weak negative correlation between adiponectin levels and increasing severity of insulin resistance (r=−0.23, p=0.005) in the groups of obese subjects. Mean serum adiponectin level in subjects with MS was lower than in subjects without MS (p=0.008).Conflict of interest:None declared.

Adiponectin, Inflammation and Cardiometabolic Risk Factors in Paediatric Obese Patients: Impact of Interventional Studies

“…These risk factors are already altered in early ages in OB individuals, and changes in adiponectin levels may underlie such risk. Indeed, an association of adiponectin with metabolic risk factors [1,34] has been reported, leading to the proposal of adiponectin as a marker of cardiometabolic risk [24,35], and as a potential predictor of obesity-related co-morbidities [36,37]. An association between adiponectin levels in childhood and the probability of developing co-morbidities in the future has been also raised [21].…”

Novel Leptin Receptor Mutations Identified in Two Girls with Severe Obesity Are Associated with Increased Bone Mineral Density

“…Laboratory investigations at the age of 9.5 years showed a serum leptin level of 67.2 μg/l, which is above the reference range based on individuals with a normal BMI (3.7-11.1 μg/l) but within the range found in obese children (52.5 ± 20.2 μg/l in 151 children at the age of 12.3 ± 2.4 years and with a BMI z-score +2.7) [13]. Thyroid function, plasma insulin-like growth factor 1 (IGF1; +1.1 SDS), fasting glucose, liver enzymes, total and LDL cholesterol were normal, and serum LH, estradiol, testosterone, FSH and androstenedione were consistent with prepubertal status.…”

Low Serum Adiponectin Levels in Korean Children with a Family History of Type 2 Diabetes Mellitus

“…A number of studies have addressed the relationship between insulin resistance and adiponectin in obese children and adolescents [15,16,17]. However, there are only a few studies about the correlation between adiponectin levels and family history of T2DM in children and adolescents [18].…”