Effects of an in-patient treatment program based on regular exercise and a balanced diet on high molecular weight adiponectin, resistin levels, and insulin resistance in adolescents with severe obesity

摘要

Adiponectin, the most abundant hormone produced by adipose tissue, circulates in 3 isoforms, including high molecularnweight (HMW) adiponectin. The latter has been suggested to be a better predictor of metabolic disturbances and insulinnresistance associated with obesity. This study investigated changes in total and HMW adiponectin, resistin, andnhomeostasis model assessment (HOMA) during a 9-month in-patient treatment program based on physical exercise and anbalanced diet in 32 severely obese adolescents. Total and HMW adiponectin, resistin, and HOMA were measured at baselinen(month 0) and during the program (months 3, 6, 9). In addition, a control group of 15 teenagers served as a reference fornthe baseline assessments. At baseline, HMW adiponectin was more markedly decreased in obese adolescents than total adiponectin,nand both were lower than in controls. Conversely, resistin and HOMA were higher in obese adolescents. Duringnthe program, there was a significant change in body composition and improved insulin sensitivity among obese teenagers.nIn addition, HMW adiponectin and the ratio of HMW-to-total adiponectin increased throughout the study, whereas total adiponectinnonly increased up until the sixth month. On the contrary, resistin did not show any significant change. In obesenadolescents, a long-term combination of aerobic exercise and a balanced diet, inducing change in body composition and improvedninsulin sensitivity, markedly increased HMW adiponectin compared with total adiponectin, without any change in resistinnconcentrations. Our results thus suggest that the determination of HMW adiponectin could be more useful thannmeasurement of total adiponectin in clinical settings