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Adiponectin, Adiposity, and Insulin Resistance in Children and Adolescents

Division of Pediatric Endocrinology and Metabolism (Z.P.), Department of Epidemiology, Biostatistics, and Occupational Health (Z.P., J.O., G.P., R.W.P.), McGill University, Montreal, Québec, Canada H3A 1A2; Departments of Clinical Biochemistry (E.E.D.), Nutrition (E.L.), and Pediatrics (M.L.), Ste-Justine Hospital and Université de Montréal, Montreal, Québec, Canada H3T 1C5; and Departments of Medicine and Pediatrics (Z.P.), McMaster University Medical Centre, Hamilton, Ontario, Canada L8N 3Z5

Address all correspondence and requests for reprints to: Marie Lambert, M.D., Medical Genetics Service, Ste-Justine Hospital, 3175 Côte-Sainte-Catherine, Montréal, Québec, Canada H3T 1C5. E-mail: marie.lambert{at}umontreal.ca.

Context: Determinants of adiponectin and its association with insulin resistance (IR) are less well studied in youth than in adults.

Objectives: The objective of the study was to describe, in youth, the age- and sex-specific distribution of adiponectin concentrations and the association with demographic, anthropometric, and lifestyle factors, parental diabetes, and markers of IR.

Design, Setting, Participants: We studied 1632 French Canadian youth aged 9, 13, and 16 yr who participated in the Québec Child and Adolescent Health and Social Survey, a province-wide, school-based survey conducted in 1999.

Results: Boys had lower adiponectin concentrations than girls by 17% (P < 0.0001). At age 16 yr, mean adiponectin concentrations were 27.7% (boys, P < 0.0001) and 13.3% (girls, P < 0.0001) lower than at age 9 yr (p_interaction = 0.009). Mean adiponectin decreased for every unit increase in body mass index (BMI) Z-score by 8.1% in boys and 11.2% in girls (P < 0.0001). Growth-related change in BMI explained half the age effect in boys and all the age effect in girls. Self-reported pubertal status, physical activity, smoking, and parental diabetes were not independently associated with adiponectin. Fasting insulin and homeostasis model assessment-IR were not associated with adiponectin concentration. However, the interaction of adiponectin and BMI Z-score was significant in a multiple regression model of fasting insulin.

Conclusions: Male sex and changes in body fat may be major determinants of the decreasing adiponectin concentrations of growing youth, which are accompanied by a dissociation of adiponectin and markers of IR. The relationship between adiposity and markers of IR is attenuated in those with higher adiponectin concentrations, making adiponectin a potential intervention target or risk marker.

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