건강한 소아에서 렙틴 아디포넥틴 비와 인슐린 저항성의 관계 = The relationship between leptin adiponectin ratio and insulin resistance in healthy children

다국어 초록 (Multilingual Abstract)

Purpose:Leptin and adiponectin are two representative adipocytokines. Leptin increases, but adiponectin decreases, with obesity and insulin resistance. We aimed to study the relationship between the leptin/adiponectin ratio and insulin resistance in healthy children.
Methods:Seventy-seven healthy children (36 boys and 41 girls) were enrolled in this study. Anthropometric measurements were performed, and the percentage of weight for height (%WFH) was calculated in each subject. Fasting plasma levels of glucose, insulin, leptin, adiponectin, testosterone, estradiol, and sex-hormone binding globulin (SHBG) were measured. The free androgen index (FAI) was used as a representative of testosterone bioactivity. The homeostasis model assessment was used to estimate the degree of insulin resistance (HOMA-IR).
Results:In the boys, HOMA-IR was significantly correlated with age, pubertal stage, free androgen index (FAI), leptin, and the leptin/adiponectin ratio. HOMA-IR was also significantly related to age, percentage of weight for height (%WFH), pubertal stage, estradiol, leptin, and the leptin/adiponectin ratio in girls. The leptin/adiponectin ratio was independently related to HOMA-IR after adjusting for age, %WFH, and FAI in the boys (P<0.05). The leptin/adiponectin ratio was not independently related to HOMA-IR after adjusting for age, %WFH, and estradiol in girls.
Conclusion:In non-obese healthy children, the leptin/adiponectin ratio was significantly correlated with insulin resistance. The leptin/adiponectin ratio was independently related to insulin resistance even after adjusting for age, degree of obesity, and androgen levels in healthy boys. (Korean J Pediatr 2008;51:256-261)

다국어 초록 (Multilingual Abstract)

Purpose:Leptin and adiponectin are two representative adipocytokines. Leptin increases, but adiponectin decreases, with obesity and insulin resistance. We aimed to study the relationship between the leptin/adiponectin ratio and insulin resistance in healthy children.
Methods:Seventy-seven healthy children (36 boys and 41 girls) were enrolled in this study. Anthropometric measurements were performed, and the percentage of weight for height (%WFH) was calculated in each subject. Fasting plasma levels of glucose, insulin, leptin, adiponectin, testosterone, estradiol, and sex-hormone binding globulin (SHBG) were measured. The free androgen index (FAI) was used as a representative of testosterone bioactivity. The homeostasis model assessment was used to estimate the degree of insulin resistance (HOMA-IR).
Results:In the boys, HOMA-IR was significantly correlated with age, pubertal stage, free androgen index (FAI), leptin, and the leptin/adiponectin ratio. HOMA-IR was also significantly related to age, percentage of weight for height (%WFH), pubertal stage, estradiol, leptin, and the leptin/adiponectin ratio in girls. The leptin/adiponectin ratio was independently related to HOMA-IR after adjusting for age, %WFH, and FAI in the boys (P<0.05). The leptin/adiponectin ratio was not independently related to HOMA-IR after adjusting for age, %WFH, and estradiol in girls.
Conclusion:In non-obese healthy children, the leptin/adiponectin ratio was significantly correlated with insulin resistance. The leptin/adiponectin ratio was independently related to insulin resistance even after adjusting for age, degree of obesity, and androgen levels in healthy boys. (Korean J Pediatr 2008;51:256-261)

참고문헌 (Reference)

1 Buse JB, "Williams textbook of endocrinology, 10th ed" WB Saunders Co 1433-1436, 2003

2 Park JM, "Type 2 Diabetes mellitus in children" 45 : 646-653, 2002

3 Cunningham SK, "The relationship between sex steroids and sex hormone binding globulin in plasma in physiological and pathological conditions" 22 : 489-497, 1985

4 Taniguchi A, "Soluble E-selectin, leptin, triglycerides, and insulin resistance in nonobese Japanese type 2 diabetic patients" 54 : 376-380, 2005

5 Warram JH, "Slow glucose removal rate and hyperinsulinemia precede the development of type II diabetes in the offspring of diabetic parents" 113 : 909-915, 1990

6 Tsou PL, "Sex-related differences between adiponectin and insulin resistance in schoolchildren" 27 : 308-313, 2004

7 Kim MR, "Serum prostate specific antigen, sex hormone binding globulin and free androgen index as markers of pubertal development in boys" 50 : 203-210, 1999

8 Garcia-Mayor RV, "Serum leptin levels in normal children: relationship to age, gender, body mass index, pituitary- gonadal hormones, and pubertal stage" 82 : 2849-2855, 1997

9 Inoue M, "Relationship between the adiponectin-leptin ratio and parameters of insulin resistance in subjects without hyperglycemia" 55 : 1248-1254, 2006

10 Yoo EG, "Puberty and gender differences of plasma leptin, adiponectin levels, and leptin/adiponectin ratio" 11 : 170-176, 2006

11 Tschritter O, "Plasma adiponectin concentrations predict insulin sensitivity of both glucose and lipid metabolism" 52 : 239-243, 2003

12 Kim MJ, "Plasma adiponectin concentration and insulin resistance in type 2 diabetes" 27 : 260-271, 2003

13 De Lorenzo A, "Normal-weight obese syndrome: early inflammation?" 85 : 40-45, 2007

14 De Lorenzo A, "Normal weight obese (NWO) women: an evaluation of a candidate new syndrome" 16 : 513-523, 2006

15 Weiss R, "Low adiponectin levels in adolescent obesity: A marker of increased intramyocellular lipid accumulation" 88 : 2014-2018, 2003

16 Ahmed ML, "Longitudinal study of leptin concentrations during puberty: sex differences and relationship to changes in body composition" 84 : 899-905, 1999

17 Kotani K, "Leptin:adiponectin ratio as an atherogenic index in patients with type 2 diabetes: relationship of the index to carotid intima-media thickness" 48 : 2684-2686, 2005

18 Blum WF, "Leptin: the voice of the adipose tissue" 48 (48): s2-s8, 1997

19 Mukherjee R, "Leptin as a common link to obesity and hypertension" 41 : 687-695, 2005

20 Lee JM, "Insulin resistance in children and adolescents" 7 : 141-147, 2006

21 Kriketos AD, "Inflammation, insulin resistance, and adiposity" 27 : 2033-2040, 2004

22 Conwell LS, "Indexes of insulin resistance and secretion in obese children and adolescents: a validation study" 27 : 314-319, 2004

23 Lillioja S, "Impaired glucose tolerance as a disorder of insulin action: longitudinal and cross-sectional studies in Pima Indians" 318 : 1217-1225, 1988

24 Matthews DR, "Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man" 28 : 412-419, 1985

25 Paolisso G, "Giugliano D. Advancing age and insulin resistance: new facts about an ancient history" 29 : 758-769, 1999

26 Mayer EJ, "Genetic and environmental influences on insulin levels and the insulin resistance syndrome: an analysis of women twins" 143 : 323-332, 1996

27 Bottner A, "Gender differences of adiponectin levels develop during the progression of puberty and are related to serum androgen levels" 89 : 4053-4061, 2004

28 Cutfield WS, "Evaluation of HOMA and QUICKI as measures of insulin sensitivity in prepubertal children" 4 : 115-118, 2003

29 Shimomura I, "Enhanced expression of PAI-1 in visceral fat: possible contributor to vascular disease in obesity" 2 : 800-803, 1996

30 Krekoukia M, "Elevated total and central adiposity and low physical activity are associated with insulin resistance in children" 56 : 206-213, 2007

31 Vaag A, "Decreased insulin activation of glycogen synthase in skeletal muscles in young nonobese Caucasian first-degree relatives of patients with non-insulin-dependent diabetes mellitus" 89 : 782-788, 1992

32 Diamond FB Jr, "Correlates of adiponectin and the leptin/adiponectin ratio in obese and non-obese children" 17 : 1069-1075, 2004

33 Lee SY, "Clinical characteristics of type 2 diabetes in children and adolescents" 45 : 754-763, 2002

34 Kershaw EE, "Adipose tissue as an endocrine organ" 89 : 2548-2556, 2004

35 Chandran M, "Adiponectin: more than just another fat cell hormone?" 26 : 2442-2450, 2003

36 Gil-Campos M, "Adiponectin, the missing link in insulin resistance and obesity" 23 : 963-974, 2004

37 Morales A, "Adiponectin and leptin concentrations may aid in discriminating disease forms in children and adolescents with type 1 and type 2 diabetes" 27 : 2010-2014, 2004

38 Spiegelman BM, "Adipogenesis and obesity: rounding out the big picture" 87 : 377-389, 1996

39 Waelput W, "A role for leptin in the systemic inflammatory response (SIRS) and in immune response, an update" 13 : 465-475, 2006

40 Matsuhisa M, "A novel index of insulin resistance determined from the homeostasis model assessment index and adiponectin levels in Japanese subjects" 77 : 151-154, 2007