Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, 3535 Market Street, 15th Floor Suite 1578, Philadelphia, Pennsylvania 19104, USA.
J Clin Endocrinol Metab. 2011 May;96(5):1549-54. doi: 10.1210/jc.2010-2364. Epub 2011 Mar 2.
Children with obesity and insulin resistance (IR) have decreased adiponectin and have increased cardiovascular risk. Adiponectin has antiatherogenic effects, but its mechanism is unclear.
Our objectives were 1) to compare lipoprotein subclass particles among obese and lean adolescents and delineate their relationships with IR and 2) to measure relationships between adiponectin and lipoproteins and their dependence on body mass index (BMI) and/or IR. DESIGN, SETTING, PATIENTS, AND MAIN OUTCOME MEASURES: This was a cross-sectional study of 57 obese and 38 lean pubertal adolescents, measuring lipoprotein subclass particles (nuclear magnetic resonance spectroscopy), lipids, adiponectin, and homeostasis model assessment of IR (HOMA-IR).
Obese had higher low-density lipoprotein (LDL) cholesterol (P = 0.018), higher small LDL particles (LDL-P) (P < 0.0005), smaller LDL-P size (P < 0.0005), smaller high-density lipoprotein particle (HDL-P) size (P < 0.0005), lower HDL cholesterol (HDL-C) (P < 0.0005), and higher small HDL-P (P = 0.009) compared with lean. HOMA-IR was higher in obese than lean (P < 0.0005) and positively associated with triglycerides, large very LDL-P, and small HDL-P and negatively with HDL-P size in obese. Adiponectin was lower in obese than lean (P < 0.0005) and was positively associated with LDL-P size, HDL-P size, and HDL-C and negatively with triglycerides, small LDL-P, large very LDL-P, and small HDL-P in obese. Using linear regression adjusting for demographics, Tanner stage, BMI, and HOMA-IR in all adolescents, adiponectin was positively associated with LDL-P size (P = 0.028), HDL-P size (P < 0.0005), and HDL-C (P = 0.042) and negatively with small LDL-P (P = 0.009) and small HDL-P (P = 0.004).
Obese adolescents have lower adiponectin levels than lean, and a more atherogenic lipoprotein profile, associated with increased IR. Adiponectin was inversely associated with atherogenic lipoproteins in adolescents, even after adjusting for obesity and IR. This is the first such report in children, and suggests a relationship between adiponectin and lipoproteins in adolescents independent of BMI and IR.
患有肥胖症和胰岛素抵抗（IR）的儿童，其脂联素水平降低，心血管风险增加。脂联素具有抗动脉粥样硬化作用，但作用机制尚不清楚。
本研究旨在比较肥胖和消瘦青少年的脂蛋白亚类颗粒，并阐明其与 IR 的关系，测量脂联素与脂蛋白之间的关系，并确定其对体重指数（BMI）和/或 IR 的依赖性。
设计、地点、患者和主要观察指标：这是一项对 57 名肥胖和 38 名消瘦青春期青少年的横断面研究，测量脂蛋白亚类颗粒（核磁共振光谱）、脂质、脂联素和稳态模型评估的胰岛素抵抗（HOMA-IR）。
肥胖组的 LDL 胆固醇（P=0.018）、小 LDL 颗粒（LDL-P）（P＜0.0005）、LDL-P 粒径（P＜0.0005）、HDL 颗粒大小（P＜0.0005）、HDL 胆固醇（P＜0.0005）和小 HDL-P（P=0.009）均高于消瘦组。肥胖组的 HOMA-IR 高于消瘦组（P＜0.0005），且与甘油三酯、大 VLDL-P 和小 HDL-P 呈正相关，与肥胖组的 HDL-P 粒径呈负相关。肥胖组的脂联素水平低于消瘦组（P＜0.0005），且与 LDL-P 粒径、HDL-P 粒径和 HDL-C 呈正相关，与甘油三酯、小 LDL-P、大 VLDL-P 和小 HDL-P 呈负相关。在所有青少年中，通过线性回归调整人口统计学、性发育分期、BMI 和 HOMA-IR，脂联素与 LDL-P 粒径（P=0.028）、HDL-P 粒径（P＜0.0005）和 HDL-C（P=0.042）呈正相关，与小 LDL-P（P=0.009）和小 HDL-P（P=0.004）呈负相关。
肥胖青少年的脂联素水平低于消瘦青少年，且具有更易致动脉粥样硬化的脂蛋白谱，与 IR 增加有关。脂联素与青少年的致动脉粥样硬化脂蛋白呈负相关，即使在调整肥胖和 IR 后也是如此。这是在儿童中首次报道，表明脂联素与脂蛋白之间的关系独立于 BMI 和 IR。
