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Adiponectin Levels in Prepubertal Children with Prader-Willi Syndrome before and during Growth Hormone Therapy

Dutch Growth Foundation (D.A.M.F., A.C.S.H.-K.), 3016 AH Rotterdam, The Netherlands; Department of Clinical Chemistry (A.v.T.) and Netherlands Institute for Health Sciences (H.J.D.), Erasmus Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands; and Department of Pediatric Endocrinology (A.C.S.H.-K.), Erasmus Medical Center Rotterdam, 3000 CB Rotterdam, The Netherlands

Address all correspondence and requests for reprints to: D. A. M. Festen, Dutch Growth Foundation, Westzeedijk 106, 3016 AH Rotterdam, The Netherlands. E-mail: d.festen{at}erasmusmc.nl.

Context: Children with Prader-Willi syndrome (PWS) may have obesity and an abnormal body composition with a high body fat percentage, even if they have a normal body weight. Adiponectin has been inversely related to obesity and insulin resistance.

Objective: The objective of the study was to evaluate in prepubertal PWS children the following: 1) adiponectin levels, body composition, carbohydrate metabolism, and triglyceride levels; 2) associations between adiponectin and body composition, carbohydrate metabolism, and triglycerides; and 3) effects of GH treatment on these outcome measures.

Patients: Twenty prepubertal PWS children participated in the study.

Intervention: The subjects were randomized into a GH treatment group (n = 10, 1 mg/m²·d) and a non-GH-treated control group (n = 10).

Main Outcome Measures: At baseline, after 1 and 2 yr of GH treatment, fasting levels of adiponectin, glucose, insulin, and triglycerides were assessed. Body composition and fat distribution were measured by dual energy x-ray absorptiometry.

Results: PWS children had significantly higher median (interquartile range) adiponectin levels [17.1 mg/liter (13.9–23.2)] than healthy sex- and age-matched controls [11.8 mg/liter (9.7–12.5), P < 0.005]. Body fat percentage was significantly higher than 0 SD score [1.8 SD score (1.5–2.1), P < 0.001]. Adiponectin levels were inversely related to triglyceride levels (r = –0.52, P = 0.03). There was a tendency to an inverse relation with body fat percentage and body mass index, but no correlation with fasting insulin or glucose levels, the insulin to glucose ratio, or homeostasis model assessment index. During GH treatment, adiponectin levels increased significantly and did not change in randomized controls.

Conclusion: Adiponectin levels were increased, and inversely associated with triglyceride levels, in prepubertal, not overweight PWS children, although they had a relatively high body fat percentage. During GH treatment, adiponectin levels further increased, whereas no change was found in the controls, which is reassuring with respect to the development of insulin resistance during GH treatment.

This article has been cited by other articles:

				A. P. Goldstone, A. J. Holland, B. P. Hauffa, A. C. Hokken-Koelega, M. Tauber, and on behalf of speakers contributors at the Second E Recommendations for the Diagnosis and Management of Prader-Willi Syndrome J. Clin. Endocrinol. Metab., November 1, 2008; 93(11): 4183 - 4197. [Abstract] [Full Text] [PDF]