Endocrinology Department, Hospital Infantil de México Federico Gómez, Mexico, D.F., Mexico.
Arch Med Res. 2011 Feb;42(2):115-21. doi: 10.1016/j.arcmed.2011.03.002.
Childhood obesity is an important risk factor for the development of insulin resistance (IR) and its co-morbidities. However, visceral adipose tissue (VAT) rather than obesity appears to have a determining role in the development of IR. Adiponectin is considered a key molecule for protection against metabolic abnormalities related to IR. Several studies have documented that lower adiponectin concentrations are related to VAT, but the results are still controversial. We undertook this study to assess the association between VAT and adiponectin concentrations with respect to body mass index (BMI) and pubertal stage in children and adolescents.
Eighty five subjects were studied (46 prepubertal and 39 pubertal) and classified according to BMI into obese and normal weight groups. All participants were given a clinical examination. Glucose, insulin, lipid profile and adiponectin were measured. VAT was estimated using helical computed tomography.
In the prepubertal group, obese children had lower adiponectin concentrations than nonobese subjects (p <0.001) but not in pubertal group (p = 0.67). When the total population was subclassified according to VAT, those with higher VAT had greater systolic and diastolic blood pressure, triglycerides, post-load glucose, insulin and HOMA-IR (p <0.001) compared to those with less VAT. HDL-C and adiponectin values trends to diminish as VAT increased (p = 0.005 and p = 0.015, respectively).
Adiponectin concentrations are inversely associated with VAT in children. The higher amount of VAT is related to metabolic abnormalities including lower values of adiponectin, which could confer a greater risk of developing type 2 diabetes mellitus and cardiovascular disease.
儿童肥胖是胰岛素抵抗（IR）及其合并症发展的重要危险因素。然而，内脏脂肪组织（VAT）似乎比肥胖更能决定 IR 的发展。脂联素被认为是预防与 IR 相关代谢异常的关键分子。多项研究表明，较低的脂联素浓度与 VAT 有关，但结果仍存在争议。我们进行这项研究是为了评估 VAT 和脂联素浓度与儿童和青少年的体重指数（BMI）和青春期阶段之间的关系。
研究了 85 名受试者（46 名青春期前和 39 名青春期后），并根据 BMI 分为肥胖组和正常体重组。所有参与者均进行了临床检查。测量了血糖、胰岛素、血脂谱和脂联素。使用螺旋 CT 估计 VAT。
在青春期前组中，肥胖儿童的脂联素浓度低于非肥胖儿童（p <0.001），但在青春期组中则无差异（p = 0.67）。当根据 VAT 将总人群进一步细分时，那些 VAT 较高的人具有更高的收缩压和舒张压、甘油三酯、负荷后血糖、胰岛素和 HOMA-IR（p <0.001），与那些 VAT 较低的人相比。随着 VAT 的增加，HDL-C 和脂联素值呈下降趋势（p = 0.005 和 p = 0.015）。
儿童的脂联素浓度与 VAT 呈负相关。较高的 VAT 量与代谢异常有关，包括脂联素值较低，这可能会增加患 2 型糖尿病和心血管疾病的风险。
