High Molecular Weight, Rather than Total, Adiponectin Levels Better Reflect Metabolic Abnormalities Associated with Childhood Obesity

Context: Japanese are prone to obesity-induced metabolic derangement, which is linked to serum adipocytokine profile even in children. Objective: The objective of the study was to determine whether high molecular-weight adiponectin (H-Adn) more specifically relates to metabolic derangement in obese children than total adiponectin (T-Adn). Design and Setting: A case (n = 59) control (n = 28) study was performed at the pediatric clinic of a university hospital. Patients: Japanese obese children (38 boys and 21 girls) were consecutively enrolled. The ages ranged from 5 to 15 (10.3 ± 0.3; mean ± sem) yr. Nonobese children (15 boys and 13 girls) were assigned as age-matched controls. Main Outcome Measures: Serum adiponectin multimeric complexes were assayed by an ELISA kit. The relationship of adiponectin to metabolic abnormalities was evaluated. Results: T-Adn (5.1 ± 0.2 vs. 8.8 ± 0.4 μg/ml), H-Adn (1.3 ± 0.1 vs. 4.8 ± 0.4 μg/ml), and medium molecular weight-Adn were significantly lower in obese than in control children. After adjustment for age and sex, both T- and H-Adn were inversely correlated with insulin and homeostasis model of assessment-insulin resistance, whereas H-Adn (but not T-Adn) inversely correlated with visceral fat area, as determined by computed tomography. Seven obese children were estimated to have metabolic syndrome and showed selective decrease in H-Adn and H/T-Adn. Conclusion: H-Adn reflects metabolic abnormalities due to obesity better than T-Adn in children. H-Adn is associated with the development of metabolic syndrome, even in childhood.