Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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The relationship between leptin adiponectin ratio and insulin resistance in healthy children

건강한 소아에서 렙틴 아디포넥틴 비와 인슐린 저항성의 관계

  • Ahn, Gae-Hyun (Department of Pediatrics, College of Medicine, Pochon CHA University) ;
  • Kim, Shin-Hye (Department of Pediatrics, College of Medicine, Pochon CHA University) ;
  • Yoo, Eun-Gyong (Department of Pediatrics, College of Medicine, Pochon CHA University)
  • 안계현 (포천중문의과대학 소아과학교실) ;
  • 김신혜 (포천중문의과대학 소아과학교실) ;
  • 유은경 (포천중문의과대학 소아과학교실)
  • Received : 2007.10.10
  • Accepted : 2007.09.10
  • Published : 2008.03.15
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Abstract

Purpose : Leptin and adiponectin are two representative adipocytokines. Leptin increases, but adiponectin decreases, with obesity and insulin resistance. We aimed to study the relationship between the leptin/adiponectin ratio and insulin resistance in healthy children. Methods : Seventy-seven healthy children (36 boys and 41 girls) were enrolled in this study. Anthropometric measurements were performed, and the percentage of weight for height (%WFH) was calculated in each subject. Fasting plasma levels of glucose, insulin, leptin, adiponectin, testosterone, estradiol, and sex-hormone binding globulin (SHBG) were measured. The free androgen index (FAI) was used as a representative of testosterone bioactivity. The homeostasis model assessment was used to estimate the degree of insulin resistance (HOMA-IR). Results : In the boys, HOMA-IR was significantly correlated with age, pubertal stage, free androgen index (FAI), leptin, and the leptin/adiponectin ratio. HOMA-IR was also significantly related to age, percentage of weight for height (%WFH), pubertal stage, estradiol, leptin, and the leptin/adiponectin ratio in girls. The leptin/adiponectin ratio was independently related to HOMA-IR after adjusting for age, %WFH, and FAI in the boys (P<0.05). The leptin/adiponectin ratio was not independently related to HOMA-IR after adjusting for age, %WFH, and estradiol in girls. Conclusion : In non-obese healthy children, the leptin/adiponectin ratio was significantly correlated with insulin resistance. The leptin/adiponectin ratio was independently related to insulin resistance even after adjusting for age, degree of obesity, and androgen levels in healthy boys.

목 적 : 렙틴과 아디포넥틴은 대표적인 adipocytokine으로 비만도 및 인슐린 저항성이 증가함에 따라 혈중 렙틴은 증가하고 아디포넥틴은 감소하는 것으로 알려져 있다. 본 연구에서는 건강한 소아에서 렙틴/아디포넥틴 비와 인슐린 저항성 사이에 어떠한 연관성이 있는지 알아보고자 하였다. 방 법 : 7-15세의 건강한 소아 77명(남아 36명, 여아 41명)을 대상으로 하여 신체계측을 하고 공복 후 채혈하여 혈당, 인슐린, 렙틴, 아디포넥틴, 총 테스토스테론, 에스트라디올 및 SHBG를 측정하였다. 활성 남성호르몬 농도로는 FAI를, 인슐린 저항성의 척도로는 HOMA-IR을 사용하였다. 결 과 : 남아에서 HOMA-IR은 연령, 사춘기 단계, FAI, 렙틴 및 렙틴/아디포넥틴 비와 의미있는 양의 상관관계를 보였다. 여아에서는 HOMA-IR과 연령, %WFH, 사춘기 단계, 에스트라디올, 렙틴, 그리고 렙틴/아디포넥틴 비 사이에 의미있는 양의 상관성이 관찰되었다. 다중회귀분석 결과, 남아에서 렙틴/아디포넥틴 비는 연령, %WFH, 및 FAI로 보정한 후에도 HOMA-IR과 독립적인 연관성을 보였다(P=0.010). 여아에서는 렙틴/아디포넥틴 비와 HOMA-IR 사이에 독립적인 연관성을 보이지 못하였다. 결 론 : 비만하지 않은 건강한 소아에서도 렙틴/아디포넥틴 비는 인슐린 저항성과 의미있는 연관성을 보였으며, 남아에서는 연령, 비만도 및 남성호르몬 농도로 보정한 후에도 렙틴/아디포넥틴 비와 인슐린 저항성 사이에 독립적인 연관성이 있었다.

Keywords

Acknowledgement

Supported by : 대한소아내분비학회

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