Adipocytokines and Insulin Levels in Young Obese Subjects at Risk for Type II Diabetes – The STYrian Juvenile OBesity Study (STYJOBS)

Introduction: Obesity and type II diabetes are increasing tremendously in young subjects. Adipocytokines are centrally involved in metabolic abnormalities of obesity. We measured serum levels of resistin, leptin, leptin receptor, adiponectin, and insulin in obese juveniles with normal fasting BG levels, and compared them to healthy, normal weighted, juvenile controls.

Methods: Serum/plasma levels of ultra sensitive C-reactive protein (US-CRP), lipid fractions, glucose, insulin, resistin, leptin, leptin receptor, and adiponectin were determined by means of ELISA in 200 obese juveniles (BMI-SDS: 6±1.6, age: 13±2.9 years, mean ±SEM) and in 203 age matched non-obese controls. Intima-media thickness (IMT) of both common carotid arteries (CCA) was measured by ultrasonography; HOMA-Index was calculated.

Results: Resistin levels were significantly positively correlated with US-CRP (r=0.42, p<0.0001) in the obese juveniles. Leptin receptor was markedly decreased in the obese cohort (p<0.01) and correlated negatively with IMT values (r=-0.36, p<0.01). Adiponectin showed the best correlation with the increased IMT (r=-0.46, p<0.0001). No correlation between BG and adiponectin levels, and between BMI-SDS and the HOMA-Index was found in the obese subjects. However, adiponectin levels were significantly lower in the obese patients with fasting BG levels >110mg/dl (p<0.05), and the HOMA-Index was significantly higher in the subjects with BMI-SDS values >5.0 (p<0.05).

Conclusion. Our data indicate the close relationship between incipient insulin resistance, and low grade inflammation in juvenile obesity. This very early state of type II diabetes is already associated with preatherosclerotic symptoms such as an increased IMT of CCA. Adiponectin may play an important role in the pathogenesis of type II diabetes and in early vascular changes.