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High Molecular Weight, Rather than Total, Adiponectin Levels Better Reflect Metabolic Abnormalities Associated with Childhood Obesity

Department of Pediatrics (S.A., K.D., K.K., A.S.), School of Medicine, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan; and Kanagawa Health Service Association (K.A.), Yokohama 231-0021, Japan

Address all correspondence and requests for reprints to: Kazushige Dobashi, M.D., Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan. E-mail: kdobashi{at}med.uoeh-u.ac.jp.

Context: Japanese are prone to obesity-induced metabolic derangement, which is linked to serum adipocytokine profile even in children.

Objective: The objective of the study was to determine whether high molecular-weight adiponectin (H-Adn) more specifically relates to metabolic derangement in obese children than total adiponectin (T-Adn).

Design and Setting: A case (n = 59) control (n = 28) study was performed at the pediatric clinic of a university hospital.

Patients: Japanese obese children (38 boys and 21 girls) were consecutively enrolled. The ages ranged from 5 to 15 (10.3 ± 0.3; mean ± SEM) yr. Nonobese children (15 boys and 13 girls) were assigned as age-matched controls.

Main Outcome Measures: Serum adiponectin multimeric complexes were assayed by an ELISA kit. The relationship of adiponectin to metabolic abnormalities was evaluated.

Results: T-Adn (5.1 ± 0.2 vs. 8.8 ± 0.4 µg/ml), H-Adn (1.3 ± 0.1 vs. 4.8 ± 0.4 µg/ml), and medium molecular weight-Adn were significantly lower in obese than in control children. After adjustment for age and sex, both T- and H-Adn were inversely correlated with insulin and homeostasis model of assessment-insulin resistance, whereas H-Adn (but not T-Adn) inversely correlated with visceral fat area, as determined by computed tomography. Seven obese children were estimated to have metabolic syndrome and showed selective decrease in H-Adn and H/T-Adn.

Conclusion: H-Adn reflects metabolic abnormalities due to obesity better than T-Adn in children. H-Adn is associated with the development of metabolic syndrome, even in childhood.

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