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Reversal of Obesity-Related Hypoadiponectinemia by Lifestyle Intervention: A Controlled, Randomized Study in Obese Adolescents

Nemours Children’s Clinic (P.B., D.G., V.F.) and University of Florida (H.Y., E.B.), Jacksonville, Florida 32207

Address all correspondence and requests for reprints to: Prabhakaran Balagopal, Ph.D., Nemours Children’s Clinic, 807 Children’s Way, Jacksonville, Florida 32207. E-mail: bbalagop{at}nemours.org.

Context: Hypoadiponectinemia and chronic subclinical inflammation in adults are associated with the development of diabetes and cardiovascular disease. The potential relationship between adiponectin and inflammation and its modulation by lifestyle intervention in the pediatric obese population remain unclear.

Objectives: The objectives were to investigate in adolescents 1) the relationship between adiponectin and obesity-related inflammatory factors, C-reactive protein, and IL-6; and 2) the effect of a lifestyle intervention on adiponectin and whether these effects are related to changes in inflammatory factors.

Research Methods and Procedures: Twenty-one obese and age-matched lean adolescents (age, 14–18 yr; Tanner stage, IV) were studied cross-sectionally. Fifteen obese adolescents also underwent a randomized, controlled physical activity-behavior-diet-based lifestyle intervention for 3 months. Associations among adiponectin, fat mass, insulin resistance, and inflammatory factors at baseline as well as after the intervention were assessed.

Results: Plasma adiponectin concentration was lower (P < 0.001) in the obese vs. age-matched lean adolescents. Significant inverse relationships were observed between adiponectin and inflammatory factors, insulinemia, insulin resistance, and fat mass. Intervention produced a 34% increase in adiponectin concentration (P = 0.0004) despite negligible weight loss but with reductions in fat mass, hyperinsulinemia, insulin resistance, and inflammatory factors (all P < 0.01).

Conclusions: The data suggest that in adolescents, obesity-related hypoadiponectinemia is associated with subclinical inflammation, and a short-term lifestyle intervention augments adiponectin concentrations. These effects appear to be related to reductions in fat mass and inflammatory factors. Based on our current understanding of adiponectin physiology, reversal of hypoadiponectinemia in obese adolescents may protect against risks for cardiovascular disease and diabetes.

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