Elevated visfatin levels in overweight and obese children and adolescents with metabolic syndrome

Objective: Adipokines have been implicated in the pathogenesis of metabolic syndrome (MetS) and insulin resistance. We investigated the association between these conditions and serum levels of visfatin, adiponectin and leptin. Material and methods: 175 overweight and obese boys and girls aged 3-17 years. MetS was defined as presence of at least three of the following: triglycerides >= 1.24 mmol/L, high-density lipoprotein cholesterol <= 1.03 mmol/L, fasting glucose >= 6.1 mmol/L, elevated waist circumference and systolic or diastolic blood pressure >= 90th percentile. Results: After adjustment for age and gender visfatin levels were significantly higher (median 19.0 [ 25th, 75th percentiles 11.9, 37.1] vs. 15.2 [ 11.6, 21.1] ng/ml; p(adjusted) = 0.02) in subjects with MetS (n = 41) compared to subjects without (n = 134). There were no significant differences in adiponectin or leptin levels between the two groups after adjustment for age and gender. Visfatin levels increased proportionally with number of MetS components (beta = 0.16, 95% CI 0.04, 0.28; p(adjusted) = 0.01), and adiponectin levels decreased proportionally with number of components (beta = -0.11, 95% CI -0.18, -0.04; p(adjusted) = 0.002). Leptin levels were not related to number of components of MetS. Unlike visfatin, both adiponectin (beta = -0.24, 95% CI -0.33, -0.15; p(adjusted) < 0.001) and leptin (beta = 0.14, 95% CI 0.01, 0.28; p(adjusted) = 0.03) were associated with insulin resistance. Conclusion: The elevation of visfatin observed in children and adolescents with MetS was proportionate to number of components of MetS but was not associated with insulin resistance. The increase in visfatin may contribute to low-grade systemic inflammation associated with MetS.