Altered distribution of adiponectin isoforms in children with Prader-Willi syndrome (PWS): association with insulin sensitivity and circulating satiety peptide hormones
Altered distribution of adiponectin isoforms in children with Prader-Willi syndrome (PWS): association with insulin sensitivity and circulating satiety peptide hormones
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DOI：
10.1111/j.1365-2265.2007.02991.x
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发表时间：
2007-12-01
影响因子：
3.2
通讯作者：
Freemark, Michael S.
中科院分区：
文献类型：
--
作者：
Haqq, Andrea M.;Muehlbauer, Michael;Freemark, Michael S.
目的Prader-Willi综合征（PWS）是一种以严重肥胖但胰岛素敏感性正常或增高的相对低胰岛素血症为特征的遗传性综合征。我们假设这种增加的胰岛素敏感性是由增加的总脂联素和高分子量脂联素水平介导的，并与饱腹感激素水平的变化有关。中分子量（MMW）和低分子量（LMW）脂联素]和饱腹激素在14名PWS儿童[中位年龄11中心点35岁，结果与肥胖对照组相比，尽管体重指数Z评分和瘦素水平相当，但PWS儿童的空腹胰岛素和HOMA-IR（胰岛素抵抗的稳态模型评估）评分较低。对于任何给定的BMI Z评分，PWS儿童显示出较高的空腹总脂联素和HMW脂联素浓度以及较高的HMW/总脂联素比值。高分子量/总脂联素比率在高度肥胖的PWS儿童中保持不变。PWS患儿空腹血浆总脂联素、高分子量脂联素及高分子量脂联素/总脂联素比值与年龄（P < 0中点05）、HOMA-IR（P < 0中点01）、BMI Z评分（P < 0中点05）、胰岛素（P < 0中点01）和瘦素（P < 0中点05）呈负相关。除了更高的空腹ghrelin浓度，PWS儿童表现出显着更高的总肽YY（PYY）和抑胃多肽（GIP）的空腹水平相比，肥胖controls.Conclusions相对于控制类似的年龄和BMI Z-score，PWS儿童有显着较高的总和HMW脂联素水平，并增加HMW/总脂联素的比例。这些发现可以部分解释PWS儿童相对于BMI匹配的对照组的胰岛素敏感性升高。
Objective Prader-Willi syndrome (PWS) is a genetic syndrome characterized by relative hypoinsulinaemia and normal or increased insulin sensitivity despite profound obesity. We hypothesized that this increased insulin sensitivity is mediated by increased levels of total and high molecular weight adiponectin and associated with changes in levels of satiety hormones.Design, patients and measurements We measured total adiponectin and its isoforms [high molecular weight (HMW), middle molecular weight (MMW) and low molecular weight (LMW) adiponectin] and satiety hormones in 14 children with PWS [median age 11 center dot 35 years, body mass index (BMI) Z-score 2 center dot 15] and 14 BMI-matched controls (median age 11 center dot 97 years, BMI Z-score 2 center dot 34).Results Despite comparable BMI Z-scores and leptin levels, the PWS children exhibited lower fasting insulin and HOMA-IR (homeostasis model assessment of insulin resistance) scores compared to obese controls. For any given BMI Z-score, the PWS children showed higher concentrations of fasting total and HMW adiponectin and higher HMW/total adiponectin ratios. The HMW/total adioponectin ratio was preserved in children with PWS at high degrees of obesity. In PWS children, fasting plasma total adiponectin, HMW adiponectin and HMW/total adiponectin ratio correlated negatively with age (P < 0 center dot 05), HOMA-IR (P < 0 center dot 01), BMI Z-score (P < 0 center dot 05), insulin (P < 0 center dot 01) and leptin (P < 0 center dot 05). In addition to higher fasting ghrelin concentrations, the PWS children showed significantly higher fasting levels of total peptide YY (PYY) and gastric inhibitory polypeptide (GIP) compared to obese controls.Conclusions Relative to controls of similar age and BMI Z-score, the PWS children had significantly higher levels of total and HMW adiponectin, and increased ratios of HMW/total adiponectin. These findings may explain in part the heightened insulin sensitivity of PWS children relative to BMI-matched controls.