The Relationship Between Adiponectin, Resistin And Insulin Resistance In Children And Adolescents With Metabolic Syndrome

BackgroundMetabolic syndrome (MS) is a series of metabolic abnormalities based on the insulin resistance, including obese, hypertension, and blood fat and sugar tolerance abnormalities. MS and another risk factor of angiocardiopathy (atherosclerosis in early lifetime) are found in children and adolescents ;and atherosclerosis simultaneously. However, there were not unified diagnostic criteria for MS since the concept of "X syndrome" was proposed by Reaven in 1988. In 1999, WHO adopted the name of "metabolic syndrome" and definite the diagnostic criteria. Third report of the National Cholesterol Education Program Expert Panel on Detection - Adult Treatment Panel III (NCEP-ATPIII) produced a new diagnostic criteria for MS in 2001 and Weiss modified the criteria for MS in children and adolescents in 2004. In our country, the prevalence of MS in children and adolescents were not reported previously. Adiponectin and resistin, secreted by adipocytes, are believed to be associated with insulin resistance, MS and atherosclerosis in adults. It is required to study the levels of blood adiponectin and resistin in children and adolescent, especially in pediatric patients with obese or MS, the association between obese, MS and insulin resistin.ObjectiveThis study aims to investigate the prevalence of MS in obesity children and adolescents in our country, and study the association between serum adiponectin, resistin and insulin resistance.SubjectsIn this study, 202 cases of obesity children and adolescents aged from 7 to 16 years in our unit were enrolled from July 2003 to Oct 2004. We definite the obesity as weight over 97 percentile of the children with same age and gender which investigated in 9 cities in 1995 without endocrinological and genetic metabolic disease. All these obesity cases included 129 males and 73 females. 109 cases were in prepuberty (Tanner stage I) and 93 in adolescent age (Tanner stage II -IV). The body mass index (BMI) of 149 cases were ranged from 23 to 30, and 53 cases were equal or over 30.In order to controlling the age, gender and sex development, 41 cases with MS (MS group), 46 cases of simple obesity without abnormality of biochemistry or complication (Simple obesity group) and 30 cases of healthy non-obesity control (control group) were selected randomly according the matching of age, gender and sex development.MS was diagnosed if someone involved 3 or more than 3 items according to the criteria of Weiss: obesity, systolic pressure or diastolic pressure over 95 percentile in children with same age and gender, blood triglyeride (TG) over 95 percentile or high density lipoprotein cholesterol (HDL-C) lower than 5 percentile, impair glucose tolerance (IGT) or type 2 diabetes mellitus.MethodsHeight, weight, blood pressure and Tanner stage were examined. Biochemical indicator, included fasting glucose, fasting insulin, TG, cholesterol, HDL-C and LDL-C were measured. Oral glucose (1.75g/kg, no more than 75g) tolerance test (OGTT) was also done and serum glucose and insulin were measured in 0 min, 30 min, 1 h, 2 h and 3 h. The levels of serum fasting adiponectin and resistin were measured by ELISA method.Whole body insulin sensitivity index (WBISI) was defined as 10000/{[FINS (mU/L) × FPG(mg/dl)] × [mean insulin (mU/L) × mean glucose (mg/dl)]}^1/2. The ratio of increment of insulin to that of plasma glucose of the initial 30 min (AI30/A G₃₀) was calculated as (0.5hINS-FINS)/(0.5hPG-FPG) and area under the curve of glucose (AUCg) calculated as =FPG/2+1hPG+2hPG+3hPG/2. Statistical analyses were conducted by using SPSS software (11.0). Differences were considered statistically significant at P<0.05. Fisher test was used to measure the enumeration data between subgroups. Skewed data were transformed logarithmically before performing a statistical analysis. The statistical significance between means was estimated by one-way ANOVA. Pearson correlation analysis was used to analyze the association between different variances/factors.Results1. The incidence of MS in obese cases36.1% (73 cases) had MS in all...