Adiponectin independently predicts metabolic syndrome in overweight Latino youth

Context: Adiponectin may be important in the pathogenesis of insulin resistance and the metabolic syndrome in youth. Objective: The objective of the study was to determine the unique effect of adiponectin on the metabolic syndrome in overweight Latino youth. Participants: Participants included 175 overweight children ( aged 11.1 +/- 1.7 yr, body mass index percentile 97.3 +/- 2.9) with a family history of type 2 diabetes. Methods: Metabolic syndrome was defined according to a pediatric adaptation of the Adult Treatment Panel III report and included dyslipidemia, abdominal obesity, elevated blood pressure, and prediabetes ( impaired fasting glucose or impaired glucose tolerance from a 2-h oral glucose tolerance test). Body composition was estimated via dual-energy x-ray absorptiometry, insulin sensitivity was quantified by the frequently sampled iv 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-h glucose levels ( P < 0.05) and positively related to high-density lipoprotein-cholesterol ( P < 0.001). In multiple linear regression, adiponectin was significantly related to triglycerides ( P < 0.01) and high-density lipoprotein-cholesterol ( P < 0.01) independent of age, gender, Tanner stage, body composition, and insulin sensitivity. Analyses of covariance established that adiponectin levels were approximately 25% higher in healthy overweight youth, compared with those with the metabolic syndrome ( 12.5 +/- 3.5 vs. 9.4 +/- 2.8 mu g/ml; 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: Hypoadiponectinemia is an independent biomarker of the metabolic syndrome, and thus, adiponectin may play a role in the pathophysiology of the disorder in overweight youth.