Adiponectin and catecholamine concentrations during acute exercise in children with type 1 diabetes.

OBJECTIVE

Adiponectin, an adipokine secreted by the adipocyte, is inversely related to adiposity and directly related to insulin sensitivity. In type 1 diabetes mellitus (T1DM), however, data thus far are contradictory. We investigated the relationship between adiponectin and exercise inT1DM.

METHODS

Forty-nine children (14.5 +/- 2.0 yr, range 8-17 yr) with T1DM on an insulin pump were studied during two 75-min exercise sessions with and without continuation of the basal rate within 4 wk. Adiponectin and epinephrine concentrations were measured before and during exercise.

RESULTS

Mean preexercise adiponectin concentration was 11.2 +/- 4.7 mg/L (range 2.7-23.0 mg/L) with a mean absolute difference of 1.7 mg/L between the 2 d. Adiponectin concentrations did not change meaningfully during exercise (mean change: -0.1 +/- 1.2 mg/L; p = 0.17). Adiponectin correlated inversely with body mass index percentile (p = 0.02) but not with age, gender, duration of diabetes, hemoglobin A1c, or preexercise glucose. However, those with higher baseline adiponectin concentrations were less likely to become hypoglycemic during exercise, 36% becoming hypoglycemic when baseline adiponectin concentration was <10 mg/L, 42% when 10 to <15 mg/L, and 15% when > or =15 mg/L (p = 0.02). Baseline epinephrine concentrations were not associated with adiponectin, and in those whose nadir glucose was < or =100 mg/dL, there was no correlation between epinephrine response and adiponectin (p = 0.16).

CONCLUSIONS

Adiponectin concentrations are stable from day to day, are not affected by acute exercise or metabolic control, and vary inversely with adiposity. Higher adiponectin concentration appears to be associated with a decrease in hypoglycemia risk during exercise. Further studies are needed to examine whether adiponectin protects against exercise-induced hypoglycemia by directly enhancing the oxidation of alternate fuels.