Adiponectin : distribution, and associations with age, sex, adiposity, lifestyle factors, family history and insulin resistance in children and adolescents

Abstract

Adiponectin is inversely related to obesity, insulin resistance and progression to type 2 diabetes in adults. However its distribution, determinants and its association with insulin resistance (IR) are less well studied in the pediatric population. The objectives of this study were to describe, in youth, the age- and sex-specific distribution of adiponectin concentrations, and its association with demographic, anthropometric, and lifestyle factors, parental diabetes, and markers of JR. This study was a secondary analysis of a sample of 1632 French Canadian youth aged 9, 13 and 16 years who participated in the Quebec Child and Adolescent Health and Social Survey, a province-wide school-based survey conducted in 1999. Boys had lower adiponectin concentrations than girls by 17% (p<0.0001). Adiponectin concentrations decreased by age-group to a greater extent in boys than girls over the age range studied (27.7% vs. 13.3%, pinteraction=0.009). Mean adiponectin decreased by 8.1% in boys and 11.2% in girls (p<0.0001) for every unit increase in BMI Z-score. 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 HOMA-IR were not associated with adiponectin concentration after adjusting for BMI. However, an interaction term for adiponectin and BMI Z-score was significant in a multiple linear regression model with fasting insulin as the dependent variable. In conclusion, male sex and changes in body fat may be major determinants of decreasing adiponectin concentrations in growing youth. There was no association between adiponectin and markers of 1R. The relationship between adiposity and markers of IR is attenuated in those with higher adiponectin concentrations, making adiponectin a potential intervention target or risk stratification marker for which the normative data presented herein may be useful