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Association of Serum Adiponectin and Metabolic Syndrome in Children with Obesity and Nonalcoholic Fatty Liver Disease

ZHAO Xiao-yuan,DING Xiu-yuan,MENG Ling-hui,ZHANG Mei-xian,MI Jie(Department of Epidemiology,Capital Institute of Pediatrics,Beijing 100020,China)  
Objective To investigate the relationship between serum adiponectin and metabolic syndrome(MS) in children and adolescents with obesity and nonalcoholic fatty liver disease(NAFLD).Methods Four elementary schools and 4 middle schools were selected from Haidian district in Beijing with representative cluster sampling.Two hundred and eighty obese children(obese group),65 obese children with NAFLD(NAFLD group) and 264 normal weight children(healthy control group) aged 7 to 18 years were recruited from the 8 schools with uncompletely randomized sampling.Data including questionnaire,anthropometric measurements,B type ultrasonographic examination for liver were collected and fasting blood laboratory assay were determined.Variables including triglyceride(TG),adiponectin,alanine aminotransferase(ALT) and aspartate aminotransferase(AST) were skewed distribution and natural logarithmical transformations were performed.Chi-square test for category and multiple binary Logistic regression analysis were used to statistical analysis.Results Body mass index(BMI) and waist circumference(WC) in obese group and NAFLD group were higher than those in healthy control group.All the chi-square tests for trend among the 3 groups were statistically significant(P0.001).As the degree of obesity increasing,children had more adverse lipid profiles,higher fasting plasma glucose,higher aminotransferase and lower adiponectin in the 2 obese groups than controls.All the chi-square tests for trend among the 3 groups were statistically significant.All the prevalence rates of MS,high TG and high blood pressure were higher in NAFLD group than those in obese group after adjustment for sex,age in multiple binary Logistic regression analysis.The relative risk of MS was especially significant(P0.001).Conclusions Dyslipidmias and liver fuction disturbance are more serious in obese and obese with NAFLD schoolchildren than those in schoolchildren with normal weight.As the degree of obesity increasing,children have lower serum adiponectin le-vel.Adiponectin is as similarity as increased factor of insulin.It is linked to fatty organization and whole glucose regulation.Adiponectin may be as a target of evaluating MS.
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