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This version published online on August 30, 2005
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2004-2427
A more recent version of this article appeared on November 1, 2005
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Submitted on December 10, 2004
Accepted on August 23, 2005

Reversal of Obesity-related Hypoadiponectinemia by Lifestyle Intervention - A Controlled Randomized Study in Obese Adolescents

Prabhakaran Balagopal*, Donald George, Hossein Yarandi, Vicky Funanage, and Edward Bayne

Nemours Childrens Clinic and University of Florida, Jacksonville, FL

* To whom correspondence should be addressed. E-mail: bbalagop{at}nemours.org.

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

Objectives: To investigate in adolescents (i) the relationship between adiponectin and obesity-related inflammatory factors, C-reactive protein and interleukin-6; (ii) 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 to 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 three 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 hypoadiponectenemia is associated with sub-clinical 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 CVD and diabetes.
Key words: diabetes • cardiovascular disease • obesity • adiponectin • lifestyle changes • inflammation




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