Context: Adiponectin may be important in the pathogenesis of insulin resistance and the metabolic syndrome in youth.

Objective: To determine the unique effect of adiponectin on the metabolic syndrome in overweight Latino youth.

Participants: 175 overweight children (age 11.1±1.7, BMI% 97.3±2.9) with a family history of type 2 diabetes.

Methods: Metabolic syndrome was defined according to a pediatric adaptation of the ATP III report and included dyslipidemia, abdominal obesity, elevated blood pressure, and pre-diabetes (impaired fasting glucose or impaired glucose tolerance from a 2-hour OGTT). Body composition was estimated via DEXA, insulin sensitivity was quantified by the frequently sampled intravenous glucose tolerance test, visceral fat was measured using magnetic resonance imaging, and adiponectin was determined in fasting serum.

RESULTS: In simple linear regression, adiponectin was significantly and inversely related to systolic blood pressure (p<0.05), waist circumference (p<0.001), triglycerides (p<0.001), and 2-hour glucose levels (p<0.05) while positively related to HDL-cholesterol (p<0.001). In multiple linear regression, adiponectin was significantly related to triglycerides (p<0.01) and HDL-cholesterol (p<0.01) independent of age, gender, Tanner, body composition, and insulin sensitivity. Analyses of covariance established that adiponectin levels were 25% higher in healthy overweight youth compared to those with the metabolic syndrome (12.5±3.5 vs. 9.4±2.8; p<0.05). In multiple logistic regression, adiponectin was a significant independent predictor of the metabolic syndrome even after adjustment for confounders including insulin sensitivity and visceral fat.

Conclusions: Hypoadiponectemia is an independent biomarker of the metabolic syndrome and thus adiponectin may play a role in the pathophysiology of the disorder in overweight youth.