Thrifty genotype and thrifty phenotype in children with diabetes and/or obesity

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Little evidence is available regarding serum adiponectin, leptin and its relationship with glycemic control and obesity-related gene polymorphisms in childhood-onset TIDM. Blood was sampled from twenty four T1 diabetic pubertal girls (mean age : 15.9) once a year for more than three years serially. Obesity-related gene polymorphisms including uncoupling protein-1 gene (UCP1, A3826G), β3-adrenergic receptor gene (β3AR, Trp64Arg) and adiponectin gene (SNP45, 164, 276, 349) were determined by PCR direct sequences. We investigated the relationships between serum adipocytokine levels, obesity-related gene polymorphisms, glycemic control (HbA1C), daily insulin dosage, BMI and blood pressure. Serum adiponectin levels (mean : 9.60±4.64μg/ml) were negatively related with age (p=0.0025), BMI (p<0.001), systolic blood pressure (p=0.015). Serum leptin levels (mean : 16.6±11.6ng/ml) were positively related with age (p<0.001), BMI (p<0.001), systolic blood pressure (p<0.001), insulin dosage (p<0.001). No significant correlation was found between serum adiponectin/leptin levels and HbA1C. The results of gene analysis for polymorphisms were as follows : UCP1(n=24) ; A/G(15), G/G(3), A/A(6), β3AR ; T/T(17), T/A(5), A/A(2), AdipoSNP45 ; T/T(7), T/G(15), G/G(2), SNP276 ; G/G(18), T/G(6), SNP349 ; A/A(10), A/G(12), G/G(2), SNP164 ; I/I(23), I/T(1). The patients who had following gene polymorphisms (A/A and A/G in UCP1, T/T in β3AR, T/T in AdipoSNP45, A/A in AdipoSNP349) showed hyperleptinemia and hypoadiponectinemia. One patient who had a adiponectin gene SNP 164I/T showed extremely low mean serum adiponectin level (3.4±1.4μg/ml). In pubertal girls with T1DM, obesity related dysadipocytokinemia appeared and life-style intervention with weight control based on obesity-related gene polymorphisms will be important.