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O A RIGINAL RTICLES
1884
Journal of Applied Sciences Research, 9(3): 1884-1891, 2013
ISSN 1819-544X
This is a refereed journal and all articles are professionally screened and reviewed
ORIGINAL ARTICLES
Adiponectin and Adiposity Indices among Obese Primary School Children
1
Nayera E Hassan, 1Sahar A El-Masry, 1Muhammad Al-Tohamy, 1Salwa El-Batrawy, 2Ahmed
W. Abou-Zeid, 3Mona Anwar
1
Biological Anthropology Department, Medical Research Division, National Research Centre, Egypt
Oral Histopathology Department, Faculty of Dentistry, Misr International University, Egypt
3Special Needs Department, Medical Research Division, National Research, Centre, Egypt
2
ABSTRACT
Background: Adiponectin is the most abundant hormone exclusively produced by adipose tissue and
influenced by obesity. Objectives: to verify the impact of obesity on adiponectin levels in pre-pubertal children
and to find out the correlation between adiponectin levels, body composition and lipid profile. Subjects and
methods: 68 obese children, aged 9.96 + 1.32 years, were included in this study. Complete clinical examination,
anthropometry (body weight, height, waist and hip circumferences and skinfold thickness) and body
composition assessment (Fat %, fat mass “FM” and fat free mass “FFM”) were attempted. BMI, Waist/Hip
ratio, and peripheral and central adiposity were calculated. Serum adiponectin, total cholesterol (TC),
triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C)
and TC/HDL-C were measured. Results: Prevalence of obesity and overweight were 3.7%, 7.7% in boys and
7.6%, 12.6% in girls, respectively. Mean plasma concentrations of triglycerides (both sexes), LDL-C (boys)
were above those considered normal for age, while HDL-C (boys) and adiponectin (both sexes) were lower.
Impaired total cholesterol, LDL-C, HDL-C and high WC were more prominent among boys, while impaired
triglycerides was more prominent among girls. Low adiponectin level was detected among the whole sample;
boys and girls. For boys, negative significant correlations were detected between adiponectin and weight, BMI,
waist and hip circumferences, subscapular SF, fat %, triglycerides and TC/HDL-C, while detected only with
biceps SF and TC/HDL-C for girls. Conclusion: The inverse relationship between plasma adiponectin
concentrations and some adiposity markers, in obese children, was dependant on the sex in prepubertal age.
Key wrods: Adiponectin, anthropometry, body composition, lipid profile, children.
Introduction
In the past few decades, as a result of modern lifestyles, the prevalence of obesity is dramatically increasing
worldwide in both children and adults (Panagiota et al., 2012). Hence, obesity has become the major complex
and growing global childhood health problem, which poses a significant economic burden to both developed
and developing countries (Anne et al, 2008). In Egypt, the prevalence of obesity is 8.0% among Egyptian school
students; however, the prevalence of overweight is 11% (Hassan et al., 2011).
Adiponectin is an adipokine that has drawn much more attention recently. It is one of the most studied
adipokines in neonates, children, and adults (Panagiota et al., 2012). It is expressed and secreted exclusively by
differentiated adipocytes with larger amounts secreted from subcutaneous than from visceral fat (Zhang et al.,
2011; Hasani-Ranjbar et al., 2012).
It has been reported that increased body adiposity in childhood is an important risk factor for
hypoadiponectinmia in adulthood (Toprak et al., 2011). Low adiponectin levels, during childhood or
adolescence, could have negative long-term health effects (Emken et al., 2010).It can be a predictor of adverse
health outcomes such as cardiovascular disease, type II diabetes and cancer in adults, Adiponectin level that
decreases in obesity and related diseases pathology (Shargorodsky et al., 2009), might be a valuable biomarker
for identifying non-overweight children at risk for later metabolic issues (Jie et al., 2010).
So, the purpose of this research is to verify the impact of obesity on adiponectin levels in pre-pubertal
children and to find out the correlation between adiponectin levels, body composition and lipid profile.
Materials and Methods
Subjects:
Corresponding Author: Sahar A El-Masry, Biological Anthropology Department, Medical Research Division, National
Research Centre, Egypt
E-mail: masrysa@yahoo.com
1885
J. Appl. Sci. Res., 9(3): 1884-1891, 2013
The study group consisted of 68 obese children (32 boys and 36 girls), aged 9.96 + 1.32 (range 6.5-11.5
years). They were derived from a cross-sectional survey, conducted on 2083 child (874 boys and 1209 girls),
from 2 primary public schools, randomly selected, situated in Giza governorate, Egypt, during the period of
October 2009 to April 2010. These children were required to meet the following inclusion criteria: age, 7-11
years and BMI greater than the 95th percentile for age and sex based on the Egyptian Growth Reference Charts
(Ghali et al., 2008). Pupils were excluded if they had a prior major illness, including type 1 or 2 diabetes,
received medications or had a condition known to influence body composition, insulin action or insulin
secretion (e.g. glucocorticoid therapy, hypothyroidism and Cushing’s disease).
Prior to enrollment, permission to perform the study was granted by the Ministry of Education, and the
directors of the school included in the research. Parents were fully informed about the purpose and methods of
the study and signed a written consent. The children provided their verbal assent. Approval to conduct this
survey was granted by the "Ethical Committee" of the “National Research Centre”. All information and blood
samples were collected by a well-trained staff during morning visits to the schools.
Anthropometric assessment:
Each child underwent a complete physical examination, including anthropometric measures. Height,
weight, waist and hip circumferences and skinfold thickness were measured following the recommendations of
the International Biological program (Hiernaux and-Tanner, 1969). Height was measured to the nearest 0.1 cm
on a Holtain portable anthropometer, and weight was determined to the nearest 0.01 kg using Seca Scale
Balance, with the subject wearing minimal clothing and no shoes. Waist circumference (central adiposity) was
measured at the level of the umbilicus with the subject standing and breathing normally, hip circumference at
the level of the iliac crest, using non-stretchable plastic tape to the nearest 0.1 cm. Skinfold thicknesses were
taken at five sites: triceps, biceps, sub scapular, suprailiac and abdominal. Each skinfold was measured three
times on the left side of the body; with Holtain skin fold caliper to the nearest 0.2 mm, and the mean value was
recorded. The following adiposity indices were calculated:
 Body mass index (BMI): as weight (kg) divided by height (m)2. BMI was used for subject’s
classification as normal weight [<85th percentile], overweight [ > 85th percentile], and obese[> 95th percentile].
BMI was also expressed in terms of standard deviation scores (z-scores), using the Egyptian Growth Reference
Charts (Ghali et al, 2008)
 Waist/ Hip ratio (cm/cm).
 Peripheral adiposity: as the sum of triceps and biceps skinfold thickness.
 Central adiposity: as the sum of sub scapular, suprailiac and abdominal
skinfold thickness.
Body Composition:
Whole body resistance and reactance (capacitance) were measured using a Bioelectrical Impedance
Analyzer (HOLTAIN LIMITED). As specified by the manufacturer, the unit was calibrated before testing using
400-ohm resistor, and electrodes were placed on right wrist and ankle. By using pupil’s sex, age, weight and
height approximated to the nearest unit, the percentage body fat (Fat %), fat mass (FM) and fat free mass (FFM)
were derived.
Biochemical assessment:
Early morning forearm venous blood samples (10 ml) were obtained from each child; before breakfast; for
biochemical screening tests after 12-hours overnight fasting. Professional staff performed venipuncture. The
blood samples were left to clot; sera were separated by centrifugation for 10 minutes at 5000 rpm then stored at
-80 ºC until assays. Serum adiponectin levels were measured using commercially available Enzyme Linked
Immunosorbent Assay (ELISA) kits, provided by AviBion Orgenium Laboratories, Finland. Serum
concentrations of total cholesterol (TC), triglycerides (TG) and high-density lipoprotein-cholesterol (HDL-C)
were measured using commercially available kits provided by STANBIO Laboratory Inc. (1261 North Main
Street Boerne Texas 78006 USA).
LDL-C was calculated according to an equation developed by Friedewald et al., 1972 as follows:
LDL-C= Total cholesterol –Triglycerides/5+ HDL-C.
The ratio between total cholesterol and high-density lipoprotein-cholesterol (TC/HDL-C) was calculated.
Definitions:
* High WC: If WC > 90th percentile for age and sex (WHO, 1999).
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J. Appl. Sci. Res., 9(3): 1884-1891, 2013
* Dyslipideamia: Any of the following:
a.
high triglycerides [>110 mg/dL]
b.
low HDL-cholesterol [<40 mg/dL].
c.
high total cholesterol [>210 mg/dL].
* High LDL–Cholesterol [> 130 mg/dL] according to Grundy et al., 2004.
* Low adiponectin [> 3.5 μg / mL ] according to (Nien et al, 2007).
Statistical Analysis:
Data were reported as means ± standard deviations (SD) or as proportions (%). The results were evaluated
on the basis of age-specific recommended normal range values for biochemical parameters (WHO, 1999).
Statistical evaluation of the results was performed with the SPSS computer program, version 16.0. Student's
independent t test was used to examine the sex differences. Pearson’s correlation coefficients were used to
assess relationships between independent variables. The level of significance was set at a probability of less than
5% (p<0.05).
Results:
The survey; from which the present study was conducted; revealed that prevalence of obesity among 2083
primary school children was 6.0% (3.7% in boys and 7.6% in girls); their mean age was 9.83+1.43 years.
However, the prevalence of overweight (BMI lies between 85th and 95th percentile for age and gender based on
the Egyptian Growth Reference Charts) was 10.5%; 7.7% in boys and 12.6% in girls.
Anthropometric Characteristics:
Although girls was significantly heavier than boys (p= 0.026), BMI-Z score, waist and hip circumferences,
waist/hip ratio and body composition parameters did not differ significantly between genders. However, there
were highly significant gender differences in skinfold thickness, where girls had higher values in subscapular
skinfold thickness and boys had the higher values of biceps and abdominal skin fold thickness and peripheral fat
(table, 1).
Biochemical Profile:
Mean plasma concentrations of triglycerides (for both sexes), LDL-C (for boys) were above those
considered normal for age, while HDL-C (for boys) and adiponectin (for both sexes) were lower than those
considered normal for age according to WHO, 1999. On the other hand, mean total cholesterol (for both sexes),
as well as, HDL-C and LDL-C for girls were within the acceptable range. However, insignificant gender
differences were detected regarding all the biochemical profile (table, 2).
The proportion of children with impaired concentrations of lipid profiles and adiponectin, revealed that
impaired total cholesterol, LDL-C, HDL-C and high WC were more prominent among boys, while impaired
triglycerides was more prominent among girls. Low adiponectin level was detected among the total sample;
boys and girls (table, 3).
Correlation between serum adiponectin and whole body composition, fat distribution and lipid profile by
sex are presented in table 4. For boys, adiponectin had significant negative correlations with body weight, BMI,
WC, hip C, subscapular SF, fat%, triglycerides, and TC/ HDL-C, and significant positive correlations with fat
free mass and HDL-C. However, for girls, adiponectin had significant negative correlations only with biceps
skinfold thickness and TC/ HDL-C.
Table 1: Anthropometric characteristics and body composition by sex
Parameters
Boys
(N = 32)
Mean
+SD
Age
9.81
+1.23
Weight (Kg)
53.75
+12.50
Height (cm)
140.40
+9.82
BMI-Z Score
2.51
+0.41
Waist C (cm)
78.91
+8.34
Hip C(cm)
91.93
+8.40
Waist/Hip ratio
0.86
+0.04
Skinfold (mm)
Triceps
27.25
+4.62
Biceps
20.63
+4.74
Subscaular
23.93
+3.09
Girls
(N = 36)
Mean
10.09
61.00
145.17
2.66
82.76
95.64
0.87
p
+SD
+1.40
+13.57
+10.84
+0.57
+14.12
+9.16
+0.20
0.388
0.026*
0.063
0.222
0.171
0.088
0.660
25.07
16.70
26.61
+6.10
+5.63
+4.56
0.119
0.004**
0.009**
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J. Appl. Sci. Res., 9(3): 1884-1891, 2013
Suprailiac
Abdominal
Peripheral fat
Central fat
Body Composition
Fat %
Fat mass (Kg)
Fat free mass (Kg)
26.50
28.68
47.88
79.10
+4.13
+5.44
+8.34
+11.23
26.57
24.36
41.77
77.53
+6.08
+6.46
+9.50
+14.54
0.961
0.006**
0.010**
0.638
43.39
23.01
35.03
+15.24
+8.70
+6.85
39.10
25.48
38.86
+4.66
+7.62
+7.69
0.165
0.270
0.056
Table 2: Biochemical indices of the study participants by sex
Parameters
Boys
(N = 32)
Mean
Adionectin
1.80
Lipid profile
Triglycride (mg/dl)
125.86
Total Cholesterol (mg/dl)
195.13
HDL-C(mg/dl)
37.77
LDL-C(mg/dl)
132.09
TC/HDL-C
6.41
+SD
+0.45
Girls
(N = 36)
Mean
1.73
p
+SD
+0.41
0.495
+33.99
+60.94
+15.26
+61.16
+4.02
136.66
182.23
42.31
113.21
5.09
+37.83
+57.93
+19.64
+59.62
+2.44
0.222
0.374
0.298
0.205
0.113
Table 3: Distribution of the children according to the cut offs for normal and abnormal lipid profile and adiponectin
Boys
Girls
Total
N (%)
N (%)
N (%)
High WC
28 (87.5)
25 (69.4)
53 (77.9)
Lipid Profile:
Dyslipideamia
28 (87.5)
34 (94.4)
62 (91.2)
HighTriglycerides
20 (62.5)
29 (80.6)
49 (72.1)
High Total Cholesterol
16 (50.0)
6 (16.7)
22 (32.4)
Low HDL- Cholesterol
20 (62.5)
17 (47.2)
37 (54.4)
High LDL- Cholesterol
20 (62.5)
10 (27.8)
30 (44.1)
Low Adiponectin
32 (100.0)
36 (100.0)
68 (100.0)
Table 4: Correlation between serum adiponectin and whole body composition, fat distribution and lipid profile by sex
Adiponectin
Boys
Girls
r
p
r
p
Weight (Kg)
- 0.516**
0.003
- 0.067
0.698
BMI (Kg/cm²)
- 0.410*
0.020
0.024
0.892
BMI-Z Score
- 0.188
0.302
0.144
0.404
Waist C (cm)
- 0.423*
0.016
0.050
0.774
Hip C(cm)
- 0.496**
0.004
- 0.052
0.762
Waist/Hip ratio
- 0.010
0.957
0.064
0.709
Skinfold (mm)
Triceps
- 0.045
0.807
- 0.081
0.675
Biceps
- 0.143
0.435
- 0.429*
0.020
Subscaular
- 0.418*
0.017
- 0.098
0.612
Suprailiac
- 0.083
0.650
0.032
0.868
Abdominal
- 0.157
0.390
0.093
0.631
Peripheral fat
- 0.106
0.563
0.202
0.293
Central fat
0.008
0.966
0.024
0.901
Fat %
- 0.523**
0.004
0.048
0.813
Fat mass (Kg)
0.366
0.055
- 0.092
0.649
Fat free mass (Kg)
0.449*
0.017
0.209
0.296
Triglycerides
- 0.397*
0.025
0.002
0.992
Total Cholesterol
0.082
0.655
0.002
0.989
HDL- Cholesterol
0.470*
0.007
0.326
0.056
TC/HDL-C
- 0.402*
0.023
- 0.352*
0.038
LDL- Cholesterol
- 0.078
0.672
- 0.120
0.491
Discussion:
Adiponectin levels differ with age, sex and obesity. At birth, adiponectin levels are extremely high and fall
off gradually until puberty. During pubertal development an additional progressive decline in adiponectin levels
occurs mainly in boys, which leads to lower adiponectin levels compared with girls. This decline is strongly
associated with androgen levels and accounts for the sex differences seen in adults (Hannah et al., 2009).
The present study revealed that plasma adiponectin levels are significantly lower in obese children; males
and females; in comparison to those considered normal- weight for age according to WHO , 1999. This agrees
with the majority of previous studies which detected an inverse correlation of adiponectin with obesity, in both
sexes, at prepubertal or pubertal age (Araki et al., 2010 in Japan; Arslan, et al., 2010 in Turkey; Emken et al.,
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J. Appl. Sci. Res., 9(3): 1884-1891, 2013
2010 in USA; Patricia et al., 2011 in Mexico; Hassan et al., 2011 in Egypt; Zhang et al., 2011 in China; Atwa et
al., 2012 in Egypt; Gherlan et al., 2012 in Romania; Aggeloussi et al., 2012 in Greece; Ochiai et al., 2012 in
Japan). In general, adiponectin levels decrease in obese subjects regardless of definition, either by BMI or by
WC (Arnaiz et al., 2010 in Chile; Zhang et al., 2011 in China; Hasani-Ranjbar et al., 2012 in Iran), i.e. either
with abdominal obesity or with visceral obesity.
Sex difference:
The results of the current research revealed insignificant sex difference in adiponectin level. Thus, they
agree with the findings concluded by Reinehr et al., (2004) in Spain, Araki et al., 2006 in Japan, Valeria et al.,
(2009) in Italy, Hassan et al., (2011) in Egyp and Patricia et al., 2011 in Mexico. They have reported that, in
both prepubertal and pubertal children, no sex difference was found in serum adiponectin level. On the other
hand, Madeira et al., 2009 in Portugal; Emken et al., 2010 in USA; Riestra et al., 2011 in Spain; Zhang et al.,
2011 in China, have reported that, in younger children, adiponectin levels were significantly higher in girls than
in boys. The study of Nishimura et al., 2007, also showed that low level of adiponectin and male sex were
significantly correlated. Some authors attributed these ethnic differences in adiponectin level to the effect of
both genetic and environmental factors, e.g. Mediterranean diet, enriched in alcohol, nuts, and whole grains, is
associated with higher adiponectin concentration (Combs et al., 2003; Panagopoulou et al., 2008). Therefore,
such ethnic differences should be taken into account for international comparisons.
Anthropometric Characteristics:
The present study revealed that, there were insignificant sex differences regarding the studied
anthropometric parameters expect in skinfold thickness. Obese girls had highly significant higher values in
subscapular skin fold thickness indicating a tendency for central fat distribution and obese boys had highly
significant higher values of biceps and abdominal skin fold thickness and peripheral fat, indicating a tendency
for both central and peripheral fat distribution. These coincide with the previous studies (Goble et al; 1992; in
Macedonia; Mast et al, 1998; in Germany; Gültekin et al., 2005; in Turkey) which confirmed that sexual
dimorphism of fat patterning in children is to be seen in the age of 5 - 11 years. These differences are
independent of gender differences in body weight. Goble et al; 1992; recorded also insignificant sex differences
in the anthropometric measurements of Macedonian elementary school students.
The results also showed that, in boys, adiponectin had significant negative correlations with body weight,
BMI, WC, hip C, subscapular SF and fat%, and significant positive correlations with fat free mass. However, in
girls, adiponectin had significant negative correlations only with biceps skin fold thickness. This comes in
concordance with some previous studies (Atwa et al., 2012; Gherlan et al., 2012; Karmeli et al., 2012;
Nascimento et al., 2012; Ochiai et al., 2012). They reported that adiponectin levels are significantly, and
strongly negatively related to anthropometric parameters such as, body weight, body mass index (BMI), BMI-Z
score, waist circumference, waist to hip ratio, intra-abdominal fat and percentage body fat, supporting the
evidences that obesity was related to low adiponectin level
Karmeli et al., 2012 and Ochiai et al., 2012, in agreement with the current results, stated that, in children
and adults, the accumulation of visceral adipose tissue was inversely correlated with adiponectin level.
Panagopoulou et al., (2008) also stated that, in obese children, although adiponectin level was significantly
negatively correlated with the percent of total body fat, yet this difference did not reach statistical significance
except after adjustment for sex. Although, such decreased level of adiponectin has been attributed to the
accumulation of visceral fat (Wagner et al., 2008) yet, plasma adiponectin level is not a simple marker of central
fat in children (Ong et al., 2006). Zhang et al., 2011, found that low adiponectin levels exist even in the
peripheral or abdominal obesity alone and insignificant differences were observed between peripheral and
abdominal obesity. Toprak et al., 2011, also stated that childhood skinfold thickness (which represents total
body adiposity) and BMI-Z score are obesity determinants for lower adiponectin levels in young adulthood,
although these relationships are not independent of adult measures of adiposity. Ochiai et al., 2012, stated that
the correlation between adiponectin level and anthropometric variables, in obese subjects (of both genders),
were consistently higher than in the non-obese ones
On the other hand, some authors found that plasma adiponectin levels were significantly and negatively
correlated with BMI in both boys and girls (El-Mesallamy et al., 2011; Nascimento et al., 2012). Other
investigators found significant correlations between anthropometric variable and adiponectin levels, among girls
only (Ochiai et al., 2012). The different reported correlations between serum adiponectin level and
anthropometric parameters, in children and adolescents may be attributed to racial differences and sociocultural
eating habits.
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J. Appl. Sci. Res., 9(3): 1884-1891, 2013
Biochemical Profile:
The results of the present study revealed that there was insignificant sex differences detected regarding all
the biochemical profile. The proportion of children with impaired concentrations of lipid profiles and
adiponectin, revealed that impaired total cholesterol, LDL-C, HDL-C and high WC were more prominent
among boys, while impaired triglycerides was more prominent among girls. Low adiponectin level was detected
among the total sample; boys and girls. For boys, adiponectin had significant negative correlations with
triglycerides, and TC/ HDL-C, and significant positive correlations with HDL-C. However, for girls,
adiponectin had significant negative correlations only with TC/HDL-C.
Valeria et al., 2009 and Zhang et al., 2011; in agreement with the current results; stated that, in general,
serum adiponectin levels decrease with the increase in the number of metabolic syndrome components. Hulthe
et al., 2003, had reported a significant inverse relationship between hypoadiponectinmia, obesity and
dyslipidemias. Moreover, it has been concluded that, following lifestyle intervention in obese children,
adiponectin proved to be the most significant predictor of improved metabolic profile (Gabriel et al., 2010;
Zhang et al., 2011). Atwa et al., 2012, had reported that obese children with metabolic syndrome “MS” have a
significantly lower serum adiponectin level compared to obese children without “MS”.
On the other hand, Riestra et al., 2011, stated that adiponectin showed a positive correlation with HDL-C
in both genders (independently of BMI), and significantly correlated negatively with TG, LDL–C in girls,
therefore, adiponectin level is more strongly related to better lipid profile in girls than in boys. Wagner et al.,
2008, found that, although a significant correlation was found between high adiponectin levels and high HDL-C
or low TG, yet this correlation appears to be independent of body fat or childhood obesity and this may be
attributed to the independent effect of adiponectin on lipid metabolism. On the contrast, some investigators
found insignificant correlation between adiponectin and HDL-C and TG (Valeria et al., 2009).
Conclusion:
The inverse relationship between plasma adiponectin concentrations and some adiposity markers, in obese
children, was dependant on the sex in prepubertal age.
So, low plasma adiponectin level estimation can be considered as a comprehensive biomarker of the
metabolic syndrome in childhood obesity, particularly boys. It could preventing its complications, and used as a
screening tool, before applying more time-consuming techniques in obese children.
References
Aggeloussi, S., A.A. Theodorou, V. Paschalis, M.G. Nikolaidis, I.G Fatouros, E.O. Owolabi, D. Kouretas, Y.
Koutedakis, A.Z. Jamurtas, 2012. Adipocytokine levels in children: effects of fatness and training. Pediatr
Exerc Sci., 24(3): 461-471.
Anne Lenz, Frank B Diamond, 2008. Curr Opin Endocrinol Diabetes Obes., 15(1): 9-20.
Araki, S., K. Dobashi, K. Kubo, K. Asayama, A. Shirahata, 2006. High molecular weight, rather than total,
adiponectin levels better reflect metabolic abnormalities associated with childhood obesity. J Clin
Endocrinol Metab. 91(12): 5113-5116.
Araki, S., K. Dobashi, Y. Yamamoto, K. Asayama, K. Kusuhara, 2010. Increased plasma isoprostane is
associated with visceral fat, high molecular weight adiponectin, and metabolic complications in obese
children. Eur J Pediatr. 169(8): 965-970.
Arnaiz Pilar, Mónica Acevedo, Salesa Barja, Marlene Aglony, Beatriz Guzmán, Berta Cassis, Jacqueline
Carvajal, Manuel Moreno, Carlos Navarrete, 2010. Ximena Berríos. Adiponectin levels, cardiometabolic
risk factors and markers of subclinical atherosclerosis in children. Int J Cardiol., 138(2): 138-144.
Arslan Nur, Baris Erdur and Adem Aydin. Hormones and Cytokines in Childhood Obesity. Indian Pediatr.
2010; 47(10): 829-839.
Atwa, H., B. Mesbah, A. Sad, 2012. Adiponectin could be a comprehensive marker of metabolic syndrome in
obese children. S Afr J Clin Nutr., 25(2): 53-56.
Combs, T.P., A.H. Berg, M.W. Rajala, S. Klebanov, P. Iyengar, J.C. Jimenez-Chillaron, M.E. Patti, S.L. Klein,
R.S. Weinstein, P.E. Scherer, 2003. Sexual differentiation, pregnancy, calorie restriction, and aging affect
the adipocyte-specific secretory protein adiponectin. Diabetes., 52(2): 268-276.
El-Mesallamy, H.O., N.M. Hamdy, S.M. Ibrahim, 2011. Adiponectin and pro-inflammatory cytokines in obese
diabetic boys. Indian Pediatr., 48: 815-6.
Emken, B., Adar, Joyce Richey, Britni Belcher, Ya-Wen Hsu, and Donna Spruijt-Metz, 2010. Objectively
Measured Physical Activity Is Negatively Associated with Plasma Adiponectin Levels in Minority Female
Youth. Int J Pediatr Endocrinol.,10: 1-10.
1890
J. Appl. Sci. Res., 9(3): 1884-1891, 2013
Friedewald, W.T., R.I. Levy, D.S. Fredrickson, 1972. Estimation of the concentration of low density lipoprotein
in plasma, without use of the preparative ultracentrifuge. Clin. Chem., 18: 499-502.
Gabriel, Á., Martos-Moreno, Vicente Barrios, Guillermo Martínez, Federico Hawkins and Jesús Argente, 2010.
Effect of Weight Loss on High-Molecular Weight Adiponectin in Obese Children. Obesity., 18(12): 22882294.
Ghali, I., N. Salah, F. Hussien, et al., 2008. Egyptian growth curves for infants, children and adolescents. In:
Satorio A, Buckler JMH, Marazzi N, Crecere nel mondo. Ferring Publisher, Italy.
Gherlan Iuliana, Suzana Vladoiu, Florin Alexiu, Mihaela Giurcaneanu, Sabina Orosb, Andreea Brehara,
Camelia Procopiuca, 2012. Constantin Dumitrache. Adipocytokine Profile and Insulin Resistance in
Childhood Obesity. Maedica A Journal of Clinical Medicine., 7(3): 205-213.
Goble, M.M., M. Mosteller, W.B. Moskowitz and R.M. Schieken, 1992. Sex differences in the determinants of
left ventricular mass in childhood. The Medical College of Virginia Twin Study. Circulation., 85: 16611665.
Grundy, S.M., J.I. Cleeman, C.N.B. Merz, H.B.Jr Brewer, L.T. Clark, D.B. Hunninghake, et al. 2004.
Implications of recent clinical trials for the national cholesterol education program Adult Treatment Panel
III Guidelines. Circulation.; 110: 227- 239.
Gültekin, T., G. Akin, B.K. Ozer, 2005. Gender differences in fat patterning in children living in Ankara.
Anthropol Anz., 63(4): 427-37.
Hannah Kanety, Rina Hemi, Shira Ginsberg, Clara Pariente, Eleanor Yissachar, Ehud Barhod,Tohru Funahashi
and Zvi Laron, 2009. Total and high molecular weight adiponectin are elevated in patients with Laron
syndrome despite marked obesity. European Journal of Endocrinology, 161: 837-844.
Hasani-Ranjbar Shirin, Mahsa M Amoli1, Ozra Tabatabaei-Malazy, Yalda Rumi, Javad Tavakkoly-Bazzaz,
Hilda Samimi, 2012. Elnaz Abbasifarid. Effect of adiponectin gene polymorphisms on waist circumference
in patients with diabetes. Journal of Diabetes & Metabolic Disorders, pp:11:14. doi:10.1186/2251-6581-1114.
Hassan, Nayera E., EL-Ashry, Hala H., Awad, Amina H., El-Masry, Sahar A., Youssef, Mai M., Sallam, Mona
M., Anwar, Mona, 2011. Adiponectin in obese children and its association with blood pressure and
anthropometric markers. Medical Research Journal., 10(1): 1-4.
Hassan, N.E., S.A. El-Masry, W.A. Fouad, L. Sherif, A. Elwakkad, M. Anwar, S.T. Zaki, 2011. Prevalence of
metabolic syndrome among obese school students. The European e-Journal of Clinical Nutrition and
Metabolism., 6: e248- e252.
Hiernaux, J., J.M. Tanner, 1969. Growth and physical studies. In: Human Biology: A guide to field methods.
Weiner JS, Lourie SA, editors. Oxford. U.K: IBP. London, Blackwell Scientific Publications.
Hulthe, J., L.M. Hultén, B. Fagerberg, 2003. Low adipocyte-derived plasma protein adiponectin concentrations
are associated with the metabolic syndrome and small dense low-density lipoprotein particles:
atherosclerosis and insulin resistance study. Metabolism., 52: 1612-1614.
Jie Mi, Mercedes Nancy Munkonda, Ming Li, Mei-Xian Zhang, Xiao-Yuan Zhao, Ponce Cedric Wamba
Fouejeu, and Katherine Cianflone, 2010. Adiponectin and Leptin Metabolic Biomarkers in Chinese
Children and Adolescents. Journal of Obesity, 2010, Article ID 892081, 10 pages.
doi:10.1155/2010/892081.
Karmelic Ivana, Jasna Lovric, Tamara Bozina, Hana Ljubic, _Zeljka Vogrinc, Nada Bozina and Jadranka Serti,
2012. Adiponectin Level and Gene Variability Are Obesity and Metabolic Syndrome Markers in a Young
Population. Archives of Medical Research, 43: 145-153.
Madeira, I.R., C.N.M. Carvalho, F.M. Gazolla, L.W. Pinto, M.A. Borges and M.A.N. Bordallo, 2009. Impact of
obesity on metabolic syndrome components and adipokines in prepubertal children. Jornal de Pediatria,
85(3): 261-268.
Mast, M., I. Körtzinger, E. König, M.J. Müller, 1998. Gender differences in fat mass of 5-7-year old children.
Int J Obes Relat Metab Disord., 22(9): 878-84.
Nascimento Henrique, Elísio Costa, Petronila Rocha-Pereira, Carla Rego, Helena Ferreira Mansilha, Alexandre
Quintanilha, Alice Santos-Silva and Luís Belo, 2012. Cardiovascular Risk Factors in Portuguese Obese
Children and Adolescents: Impact of Small Reductions in Body Mass Index Imposed by Lifestyle
Modifications. The Open Biochemistry Journal., 6: 43-50.
Nien, J.K., S. Mazaki-Tovi, R. Romero, O. Erez, J.P. Kusanovic, F. Gotsch, B.L. Pineles, R. Gomez, S. Edwin,
M. Mazor, J. Espinoza, B.H. Yoon, S.S. Hassan, 2007. Plasma adiponectin concentrations in non-pregnant,
normal and overweight pregnant women. J Perinat Med., 35(6): 522-31.
Nishimura Rimei, Hironari Sano, Toru Matsudaira, Yumi Miyashita, Aya Morimoto, Takako Shirasawa, Eiko
Takahashi, Takeshi Kawaguchi, Naoko Tajima, 2007. Childhood obesity and its relation to serum
adiponectin and leptin: A report from a population-based study. Diabetes Res Clin Pract., 76(2): 245-250.
1891
J. Appl. Sci. Res., 9(3): 1884-1891, 2013
Ochiai Hirotaka, Takako Shirasawa, Rimei Nishimura, Aya Morimoto, Tadahiro Ohtsu, Hiromi Hoshino, Naoko
Tajima, Akatsuki Kokaze, 2012. High-molecular-weight adiponectin and anthropometric variables among
elementary schoolchildren: a population-based cross-sectional study in Japan. BMC Pediatr., 12: 139.
Ong Ken, K., Jan Frystyk, Allan Flyvbjerg, Clive J. Petry, 2006. the Avon Longitudinal Study of Parents and
Children Study Team, Andy Ness, and David B. Dunger. Sex-Discordant Associations With Adiponectin
Levels and Lipid Profiles in Children. Diabetes. 55: 1337-1341.
Panagiota Pervanidou, Makarios Eleftheriades, 2012. Ioannis Papassotiriou.. Adipokines and Anthropometry:
Childhood and Adolescent Obesity or Adipocytokines and Anthropometry in Childhood and Adolescence.
Handbook of Anthropometry, pp: 1221-1236.
Panagopoulou Paraskevi, Assimina Galli-Tsinopoulou, Alexandra Fleva, Ekaterini Pavlitou-Tsiontsi, Norma
Vavatsi-Christaki, and Sanda Nousia-Arvanitakis, 2008. Adiponectin and Insulin Resistance in Childhood
Obesity. Journal of Pediatric JPGN. 47(3): 356-362.
Patricia Medina-Bravo, Ruth Meza-Santibanez, Patricia Rosas-Fernandez, Rosa Galvan-Duarte, Renata
Saucedo-Garcıa, Lubia Velazquez Lopez, and Margarita Torres-Tamayo, 2011. Decrease in Serum
Adiponectin Levels Associated with Visceral Fat Accumulation Independent of Pubertal Stage in Children
and Adolescents. Arch Med Res., 42(2): 115-121.
Reinehr, T., C. Roth, T. Menke & W. Andler, 2004. Adiponectin before and after weight loss in obese children.
Journal of Clinical Endocrinology and Metabolism., 89: 3790-3794.
Riestra Pia, Alicia Garcia-Anguita, Miguel A. Lasuncion, Beatriz Cano, Manuel de Oya, Carmen Garcesa, 2011.
Relationship of adiponectin with metabolic syndrome components in pubertal children. Atherosclerosis.
216(2): 467-470.
Shargorodsky, M., M. Boaz, Y. Goldberg, Z. Matas, D. Gavish, A. Fux, N. Wolfson, 2009. Adiponectin and
vascular properties in obese patients: Is it a novel biomarker of early atherosclerosis? Int J Obes., 33(5):
553-558.
Toprak Demet, Toprak Ahmet, Wei Chen, Ji Hua Xu, Sathanur Srinivasan and Gerald S. Berenson, 2011.
Adiposity in Childhood Is Related to C-Reactive Protein and Adiponectin in Young Adulthood: From the
Bogalusa Heart Study. Obesity, 19(1): 185-190.
Valeria Calcaterra, Mara De Amici, Catherine Klersy, Cristina Torre, Vincenza Brizzi, Francesca Scaglia,
Michela Albanesi, Riccardo Albertini, Benedetta Allais, Daniela Larizza. 2009. Adiponectin, IL-10 and
metabolic syndrome in obese children and adolescents. Acta Biomed., 80(2): 117-23.
Wagner, A., C. Simona, M. Oujaa, C. Platat, B. Schweitzer, D. Arveiler, 2008. Adiponectin is associated with
lipid profile and insulin sensitivity in French adolescents. D. Diabetes & Metabolism., 34(5): 465-471.
WHO, 1999. criteria adapted for children. Diabetes Epidemiology Collaborative analysis of diagnostic criteria
in Europe study group, Will new diagnostic criteria for diabetes mellitus change phenotype of diabetes
Epidemiology Collaborative analysis of diagnostic criteria in Europe study group: glucose tolerance and
mortality: comparison of WHO and American diabetes association diagnostic criteria. Lancet., 354: 617621.
Zhang Meixian, Zhao Xiaoyuan, Li Ming, Cheng Hong, Hou Dongqing, Wen Yu, Katherine Cianflone, 2011.
And Mi Jie. Abnormal Adipokines Associated with Various Types of Obesity in Chinese Children and
Adolescents. Biomed Environ Sci., 24(1): 12‐21.
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