title: Fetuin-A, adiposity-linked insulin resistance and responsiveness to an educational-based weight excess reduction program: a population-based survey in prepubertal schoolchildren.
abstract: The secreted hepatokine fetuin-A emerges as an independent predictor of type 2 diabetes in adulthood. The overall aims of this study were: (1) to investigate the associations of fetuin-A with adiposity and insulin resistance, as well as its relationship with adipokines, in prepubertal children, and, (2) to evaluate whether, in prepubertal obesity, serum fetuin-A levels may either change or predict the responsiveness to an educational-based weight excess reduction program. We studied 200 prepubertal children (boys/girls: 89/111; Tanner stage 1; age: 5-13 years), included in a cohort of 44,231 adolescents who participated in an extensive Italian school-based survey. According to Cole's criteria, 100 individuals were lean (boys/girls: 57/43) and 100 obese (boys/girls: 54/46). A subset of 53 obese individuals (boys/girls: 28/25; age: 6-12 years) were also evaluated after a weight excess reduction program. Serum fetuin-A, leptin, total and high molecular weight adiponectin levels, as well as homeostasis model assessment of insulin resistance were assessed. When compared with lean, obese children exhibited higher ( p < 0.0001) fetuin-A concentrations, without differences between sex. Fetuin-A was positively associated with adiposity, homeostasis model assessment of insulin resistance, and leptin levels. In multivariate analysis, the associations between fetuin-A and leptin or homeostasis model assessment of insulin resistance lost the significance after adjustment for BMIZ-score, which, in turn, represented an independent determinant of fetuin-A (R2adj0.327; p < 0.0001). Notably, after weight excess reduction program, fetuin-A levels dropped ( p < 0.0001 vs. basal). Interestingly, no significant differences of fetuin-A concentrations between responders and no responders were found. In prepubertal children, fetuin-A represents an early marker of adiposity, and its reduction after lifestyle intervention may partly contribute to the beneficial effects of weight excess reduction program.
authors.affiliation: Department of Internal Medicine, Assisi Hospital, Assisi, Perugia, Italy. gmurdolo@tiscali.it.|Department of Medicine, University of Perugia, Perugia, Italy. gmurdolo@tiscali.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Murdolo
authors.affiliation: Department of Medicine, University of Perugia, Perugia, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Tortoioli
authors.affiliation: Department of Pediatrics, Neonatology Intensive Care, Azienda Ospedaliera S. Maria, Terni, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Celi
authors.affiliation: Department of Medicine, University of Perugia, Perugia, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Bini
authors.affiliation: Department of Medicine, University of Perugia, Perugia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Papi
authors.affiliation: Department of Medicine, University of Perugia, Perugia, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Brozzetti
authors.affiliation: Department of Medicine, University of Perugia, Perugia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Falorni
mesh_terms: D052242:Adiponectin / Q000097:blood; D050154:Adiposity / Q000502:physiology*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D020738:Leptin / Q000097:blood; D008297:Male; D009765:Obesity / Q000097:blood* / Q000628:therapy; D016896:Treatment Outcome; D061217:Weight Reduction Programs; D060749:alpha-2-HS-Glycoprotein / Q000378:metabolism*
chemical_list: D052242:Adiponectin; D020738:Leptin; D060749:alpha-2-HS-Glycoprotein
keywords: Adipokines; Childhood obesity; Fetuin-A; Insulin resistance; Weight loss