Adiponectin Is Associated with Favorable Lipoprotein Profile, Independent of BMI and Insulin Resistance, in Adolescents

Context: Children with obesity and insulin resistance (IR) have decreased adiponectin and have increased cardiovascular risk. Adiponectin has antiatherogenic effects, but its mechanism is unclear. Objectives: Our objectives were 1) to compare lipoprotein subclass particles among obese and lean adolescents and delineate their relationships with IR and 2) to measure relationships between adiponectin and lipoproteins and their dependence on body mass index (BMI) and/or IR. Design, Setting, Patients, and Main Outcome Measures: This was a cross-sectional study of 57 obese and 38 lean pubertal adolescents, measuring lipoprotein subclass particles (nuclear magnetic resonance spectroscopy), lipids, adiponectin, and homeostasis model assessment of IR (HOMA-IR). Results: Obese had higher low-density lipoprotein (LDL) cholesterol (P = 0.018), higher small LDL particles (LDL-P) (P < 0.0005), smaller LDL-P size (P < 0.0005), smaller high-density lipoprotein particle (HDL-P)size (P < 0.0005), lower HDL cholesterol (HDL-C) (P < 0.0005), and higher small HDL-P (P = 0.009) compared with lean. HOMA-IR was higher in obese than lean (P < 0.0005) and positively associated with triglycerides, large very LDL-P, and small HDL-P and negatively with HDL-P size in obese. Adiponectin was lower in obese than lean (P < 0.0005) and was positively associated with LDL-P size, HDL-P size, and HDL-C and negatively with triglycerides, small LDL-P, large very LDL-P, and small HDL-P in obese. Using linear regression adjusting for demographics, Tanner stage, BMI, and HOMA-IR in all adolescents, adiponectin was positively associated with LDL-P size (P = 0.028), HDL-P size (P = 0.0005), and HDL-C (P = 0.042) and negatively with small LDL-P (P = 0.009) and small HDL-P (P = 0.004). Conclusions: Obese adolescents have lower adiponectin levels than lean, and a more atherogenic lipoprotein profile, associated with increased IR. Adiponectin was inversely associated with atherogenic lipoproteins in adolescents, even after adjusting for obesity and IR. This is the first such report in children, and suggests a relationship between adiponectin and lipoproteins in adolescents independent of BMI and IR. (J Clin Endocrinol Metab 96: 1549-1554, 2011)