Adiponectin levels in prepubertal children with Prader-Willi syndrome before and during growth hormone therapy.
BACKGROUND
Children with Prader-Willi syndrome (PWS) may have obesity and an abnormal body composition with a high body fat percentage, even if they have a normal body weight. Adiponectin has been inversely related to obesity and insulin resistance.


OBJECTIVE
The objective of the study was to evaluate in prepubertal PWS children the following: 1) adiponectin levels, body composition, carbohydrate metabolism, and triglyceride levels; 2) associations between adiponectin and body composition, carbohydrate metabolism, and triglycerides; and 3) effects of GH treatment on these outcome measures.


METHODS
Twenty prepubertal PWS children participated in the study.


METHODS
The subjects were randomized into a GH treatment group (n=10, 1 mg/m2.d) and a non-GH-treated control group (n=10).


METHODS
At baseline, after 1 and 2 yr of GH treatment, fasting levels of adiponectin, glucose, insulin, and triglycerides were assessed. Body composition and fat distribution were measured by dual energy x-ray absorptiometry.


RESULTS
PWS children had significantly higher median (interquartile range) adiponectin levels [17.1 mg/liter (13.9-23.2)] than healthy sex- and age-matched controls [11.8 mg/liter (9.7-12.5), P<0.005]. Body fat percentage was significantly higher than 0 sd score [1.8 sd score (1.5-2.1), P<0.001]. Adiponectin levels were inversely related to triglyceride levels (r=-0.52, P=0.03). There was a tendency to an inverse relation with body fat percentage and body mass index, but no correlation with fasting insulin or glucose levels, the insulin to glucose ratio, or homeostasis model assessment index. During GH treatment, adiponectin levels increased significantly and did not change in randomized controls.


CONCLUSIONS
Adiponectin levels were increased, and inversely associated with triglyceride levels, in prepubertal, not overweight PWS children, although they had a relatively high body fat percentage. During GH treatment, adiponectin levels further increased, whereas no change was found in the controls, which is reassuring with respect to the development of insulin resistance during GH treatment.
Festen
D A M
DA
Dutch Growth Foundation, Westzeedijk 106, 3016 AH Rotterdam, The Netherlands. d.festen@erasmusmc.nl
van Toorenenbergen
A
A
Duivenvoorden
H J
HJ
Hokken-Koelega
A C S
AC
D052242:Adiponectin / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D011218:Prader-Willi Syndrome / Q000097:blood* / Q000188:drug therapy*; D014280:Triglycerides / Q000097:blood
D052242:Adiponectin; D001786:Blood Glucose; D007328:Insulin; D014280:Triglycerides; D019382:Human Growth Hormone