title: Elevated plasma pigment epithelium-derived factor in children with type 2 diabetes mellitus is attributable to obesity.
abstract: BACKGROUND
  Pigment epithelium-derived factor (PEDF) is a member of the serpin family secreted by adipocytes. Plasma PEDF is increased in obese children and adults. Adults with type 2 diabetes mellitus (T2DM) have higher circulating PEDF but there are no reports in children with T2DM.
  
  
  OBJECTIVE
  To compare PEDF concentration in children with T2DM to normal weight and obese children without T2DM and determine associations with anthropometric or serum factors.
  
  
  METHODS
  Participants were 34 obese children with T2DM diagnosed by American Diabetes Association (ADA) criteria, 61 normal weight [body mass index (BMI) 25-75 percentile] and 63 obese (BMI ≥ 95 percentile) children of age 8-18 yr. Plasma PEDF was measured in fasting plasma samples. Anthropometric, serum, and body composition (dual-energy x-ray absorptiometry, DXA) data were obtained for each subject to identify potential predictor variables.
  
  
  RESULTS
  PEDF was 55% higher (p = 0.001) in the T2DM group compared with normal weight children, but did not differ from obese children. In the T2DM group, fat mass and lean mass both individually predicted PEDF (r² = 0.22 and 0.17, p = 0.02 and p < 0.01, respectively). PEDF was positively correlated with homeostatic model assessment - insulin resistance (HOMA-IR) when all groups were combined (r² = 0.15, p<0.001).
  
  
  CONCLUSIONS
  Plasma PEDF was similar in the T2DM and obese groups, therefore, obesity, rather than diabetes, may account for the higher PEDF in children with T2DM compared with normal weight children. PEDF was positively associated with both lean mass and fat mass both of which may contribute to the circulating level of the protein, and potentially to PEDF's association with insulin resistance in obese children with and without diabetes.
authors.affiliation: Department of Pediatrics, Section of Diabetes/Endocrinology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: Jeanie B
authors.initials: JB
authors.lastname: Tryggestad
authors.affiliation: Department of Ophthalmology, School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA.|Department of Biochemistry, School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA.
authors.forename: Joshua J
authors.initials: JJ
authors.lastname: Wang
authors.affiliation: Department of Ophthalmology, School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA.|Department of Biochemistry, School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA.
authors.forename: Sarah X
authors.initials: SX
authors.lastname: Zhang
authors.affiliation: Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Thompson
authors.affiliation: Department of Pediatrics, Section of Diabetes/Endocrinology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Short
mesh_terms: D000293:Adolescent; D001823:Body Composition; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications*; D005136:Eye Proteins / Q000097:blood*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008297:Male; D009414:Nerve Growth Factors / Q000097:blood*; D009765:Obesity / Q000097:blood* / Q000150:complications*; D015843:Serpins / Q000097:blood*; D000099174:Pigment Epithelium-Derived Factor
chemical_list: D002097:C-Reactive Protein; D005136:Eye Proteins; D008055:Lipids; D009414:Nerve Growth Factors; D015843:Serpins; D000099174:Pigment Epithelium-Derived Factor
keywords: PEDF; T2DM; obesity