Endocrinology and Metabolism

The Korean Endocrine Society (대한내분비학회)
권호 표지

Relationship with Serum Adiponectin Concentrations and Obesity in Korean Children

한국 청소년에서 혈청 Adiponectin 농도와 비만도와의 상관관계

Kim, Hyoun-Ah;Lee, Hyoung-Suk;Kim, Chul-Sik;Ahn, Chul-woo;Chung, Yoon-Sok;Lee, Kwan-Woo;Huh, Kap-Bum;Kim, Dae-Jung
김현아;이형숙;김철식;안철우;정윤석;이관우;허갑범;김대중

  • Published : 20030000
⟨ Previous Next ⟩

Abstract

Background: Adiponectin is an adipocytokine that is highly specific to adipose tissue. In contrast to other adipocytokine, the adiponectin levels are decreased in obesity and/or type 2 diabetes. There are few studies regarding the correlation between the adiponectin concentration and obesity in children. Thus, whether the serum adiponectin concentrations are associated with adiposity in children was investigated. Methods: One hundred and sixty four subjects were selected from the participants in an ongoing study on the relationship between birth weight and insulin resistance in children. The current weights, heights, body fat percentages, waist circumferences, blood pressures, lipid profiles and insulin resistance, by the HOMA method, were measured in all the subjects. The serum adiponectin concentrations were determined by a validated sandwich ELISA, using a human adiponectin-specific antibody. Results: The serum adiponectin concentration was negatively correlated with the body mass index, waist circumference, systolic blood pressure, insulin resistance by HOMA and serum triglycerides, and positively correlated with the serum HDL cholesterol level. The serum adiponectin concentrations in the boys were significantly lower than in the girls. In a multiple regression analysis, the serum adiponectin concentration was strongly associated with waist circumference and gender. Conclusion: It is concluded that there was an inverse relationship between the serum adiponectin concentration and abdominal adiposity in children. However, further studies on independent gender differences on adiponectin are needed.

연구배경: Adiponectin은 지방세포에서 특이적으로 발현되고 분비되는 adipocytokine이다. 아직 adiponectin과 소아 비만과의 관련성을 연구한 보고는 많지 않다. 본 연구에서는 한국 청소년을 대상으로 혈청 adiponectin 농도와 비만도 및 심혈관계 질환의 위험인자들과의 상관관계를 보고자 하였다. 방법: 2003년 4월 서울특별시 서대문구 소재의 한 중학교에서 12~15세의 무작위 선발된 164명을 연구 대상으로 하여 신장, 체중, 허리둘레, 체지방을 측정하고 체질량지수를 계산하였다. 또한 공복채혈을 통하여 콜레스테롤, HDL-콜레스테롤, 중성지방, 혈당 및 인슐린 농도를 측정하고 혈청 adiponectin 농도는 ELISA 방법을 이용하여 측정하였다. 결과: 혈청 adiponectin 농도에 따라 삼등분하여 저 adiponectin군, 중간 adiponectin군, 고 adiponectin군으로 나누고 각 군간에 신체계측치 및 임상적 특성을 비교 분석하였다. 저 adiponectin군에서 다른 군에 비해 체질량지수가 허리둘레가 의미있게 크게 나타났다. 또한 저 adiponectin군에서 공복혈당 및 공복혈청 인슐린 농도가 높게 나타났으며, HOMA-IR 값도 높게 나타났다. 저 adiponectin군에서 총콜레스테롤과 중성 지방치는 높게, 그리고 HDL 콜레스테롤치는 낮게 나타났다. 다변량회귀분석을 시행한 결과 혈청 adiponectin 농도와 가장 상관관계가 높은 변수는 허리둘레와 성별로 나타났다. 결론: 소아에서도 성인과 마찬가지로 혈청 adiponectin 농도와 복부비만 및 심혈관계 질환의 위험인자들과의 강한 음의 상관관계를 보임을 알 수 있었다. 향후 사춘기 성호르몬의 변화가 adiponectin에 미치는 영향 및 소아비만의 치료에 따른 adiponectin의 변화 등에 대한 연구가 필요하리라 사료된다.

Keywords

References

  1. World Health Organization. 2000 Obesity: preventing and managing the global epidemic. Geneva: World Health Organization
  2. 김호진, 이승훈, 박희순, 이가영, 최영인, 황인홍, 허봉렬: 소아비만의 유병률에 관한 조사 연구. 가정의학회지 11:15-20, 1990
  3. 강윤주: 서울시내 초중고 학생들의 최근 18년간 (1979-1996) 비만도 변화추이 및 비만아 증가양상. 학교보건연보 27:98-114, 1997
  4. 이진복, 이정오, 김성원, 강재헌, 양윤준: 서울 시내 일부 초등학교 아동에서 비만의 유병률 및 위험요인. 가정의학회지 21:866-875, 2000
  5. Freedman DS, Dietz WH, Srinivasan SR, Berenson GS: The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study. Pediatrics 103:1175-1182, 1999
  6. Dabelea D, Hanson RL, Bennett PH, Roumain J, Knowler WC, Pettitt DJ: Increasing prevalence of type II diabetes in American Indian children. Diabetologia 41:904-910, 1998
  7. Maeda K, Okubo K, Shimomura I, Funahashi T, Matsuzawa Y, Matsubara K: cDNA cloning and expression of a novel adipose specific collagenlike factor, apM1 (AdiPose Most abundant Gene transcript 1). Biochem Biophys Res Commun 221:286-289, 1996
  8. Yamauchi T, Kamon J, Waki H, Terauchi Y, Kubota N, Hara K, Mori Y, Ide T, Murakami K, Tsuboyama-Kasaoka N, Ezaki O, Akanuma Y, Gavrilova O, Vinson C, Reitman ML, Kagechika H, Shudo K, Yoda M, Nakano Y, Tobe K, Naga i R, Kimura S, Tomita M, Froguel P, Kadowaki T: The fat-derived hormone adiponectin reverses insulin resistance associated with both lipoatrophy and obesity. Nat Med 7:941-946, 2001
  9. Arita Y, Kihara S, Ouchi N, Takahashi M, Maeda K, Miyagawa J, Hotta K, Shimomura I, Nakamura T, Miyaoka K, Kuriyama H, Nishida M, Yamashita S, Okubo K, Matsubara K, Muraguchi M, Ohmoto Y, Funahashi T, Matsuzawa Y: Paradoxical decrease of an adiposespecific protein, adiponectin, in obesity. Biochem Biophys Res Commun 257:79-83, 1999
  10. Hotta K, Funahashi T, Arita Y, Takahashi M, Matsuda M, Okamoto Y, Iwahashi H, Kuriyama H, Ouchi N, Maeda K, Nishida M, Kihara S, Sakai N, Nakajima T, Hasegawa K, Muraguchi M, Ohmoto Y, Nakamura T, Yamashita S, Han afusa T, Matsuzawa Y: Plasma concentrations of a novel, adipose-specific protein, adiponectin, in type 2 diabetic patients. Arterioscler Thromb Vasc Biol 20:1595-1599, 2000
  11. Weyer C, Funahashi T, Tanaka S, Hotta K, Matsuzawa Y, Pratley RE, Tataranni PA: Hypoadiponectinemia in obesity and type 2 diabetes: close association with insulin resistance and hyperinsulinemia. J Clin Endocrinol Metab 86:1930-1935, 2001
  12. Ouchi N, Kihara S, Arita Y, Maeda K, Kuriyama H, Okamoto Y, Hotta K, Nishida M, Takahashi M, Nakamura T, Yamashita S, Funahashi T, Matsuzawa Y: Novel modulator for endothelial adhesion molecules: adipocytederived plasma protein adiponectin. Circulation 100:2473-2476, 1999
  13. Stefan N, Bunt JC, Salbe AD, Funahashi T, Matsuzawa Y, Tataranni PA: Plasma adiponectin concentrations in children: relationships with obesity and insulinemia. J Clin Endocrinol Metab 87:4652-4656, 2002
  14. Nemet D, Wang P, Funahashi T, Matsuzawa Y, Tanaka S, Engelman L, Cooper DM: Adipocytokines, body composition, and fitness in children. Pediatr Res 53:148-152, 2003
  15. Weiss R, Dufour S, Groszmann A, Petersen K, Dziura J, Taksali SE, Shulman G, Caprio S: Low adiponectin levels in adolescent obesity: a marker of increased intramyocellular lipid accumulation. J Clin Endocrinol Met ab 88:2014-2018, 2003
  16. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC: Homeostasis model assessment: insulin resistance and beta-call function from fasting plasma glucose and insulin concentrations in man. Diabet ologia 28:412-419, 1985
  17. 이가영, 김진경, 이남수, 한정희, 전혜련: 비만한 소아 및 청소년에서 치료에 따른 체중 감량과 관련된 요인. 대한비만학회지 11:302, 2002
  18. 홍영미, 문겨래, 서정완, 심재견, 유기환, 정병주, 최연호, 하은희, 이동환, 박재옥, 양세원, 이종국, 임인석, 차성호. 홍창호, 최중명: 소아 비만의 진단과 치료지침. 소아과 42:1338~1365, 1999
  19. Ukkola O, Santaniemi M: Adiponectin: a link between excess adiposity and associated comorbidities. J Mol Med 80:696-702, 2002
  20. Cnop M, Havel PJ, Utzschneider KM, Carr DB, Sinha MK, Boyko EJ, Retxlaff BM, Knopp RH, Brnzell JD, Kahn SE: Relationship of adiponectin to body fat distribution, insulin sensitivity and plasma lipoproteins: eviden ce for independent roles of age and sex. Diabetologia 46:459-469, 2003
  21. Yang WS, Lee WJ, Funahashi T, Tanaka S, Matsuzawa Y, Chao CL, Chen CL, Tai TY, Chuang LM: Weght reduction increases plasma levels of an adipose-derived anti-inflammatory protein, adiponectin. J Clin Endocrinol Met ab 86:3815-3819, 2001
  22. Weiss R, Dufour S, Groszmann A, Petersen K, Dziura J, Taksali SE, Shulman G, Caprio S: Low adiponectin levels in adolescent obesity: a marker of Increased Intramyocellular lipid accumulation. J Clin Endocrinol Met ab 88:2014-2018, 2003