Obesity or overweight occur in 40% of U.S. youth with T1D. While BMI is used to define obesity, it may not accurately reflect excess adiposity, which correlates better with metabolic dysfunction. However, it is difficult to measure adiposity without a research setting. In contrast, adipokines, which are produced by the adipose tissue, can be measured in serum. We aimed to analyze, in youth with T1D and obesity, the relationships of serum adipokines with measures of adiposity and cardiovascular risk factors.

We studied participants in the T1D Exchange Metformin Study with a serum sample obtained before randomization (n=61, mean age=8.0 years [SD=3.0], 27.9% male, 82.0% non-Hispanic white, mean BMI percentile=99.0 ([SD=1.0], mean BMI Z-score=2.7 [SD=0.78], mean % of the 95th BMI percentile (%95th BMI pctle)=134.6 [SD=20.0]). We measured serum levels of adipokines and inflammatory markers. We studied the correlations between DEXA scan-derived measures of adiposity (e.g., % body fat) with adipokines (e.g., leptin, adiponectin) or anthropometric measures (e.g., % 95th BMI pctle [recommended measure for extreme obesity], BMI-Z score).

DEXA % body fat was significantly correlated with % 95th BMI pctle (r=0.494, p<0.0001) or leptin (r=0.467, p=0.0002), without statistical difference between these two correlations (p = 0.857). The correlation between % body fat and BMI Z-score was weaker (r=0.29, p=0.0270). Higher adiponectin was correlated with cardiovascular protective factors, such as lower systolic blood pressure (p=0.039) and higher HDL cholesterol (p=0.001), while neither % 95th BMI pctle nor BMI Z-score were. Children with high adiponectin (>26.5 mg/L, distribution mean) were less likely to have high CRP >6 mg/L (1.6%) vs. children with low adiponectin (23.0%, p<0.05).

Serum adipokines levels could be used as more convenient markers of adiposity than BMI measures, and potentially become therapeutic targets to improve clinical outcomes in children with T1D and obesity.


M.J. Redondo: None. X. Gu: None. S. Sisley: Advisory Panel; Self; Rhythm Pharmaceuticals, Inc. M. Tosur: None. A.F. Siller: None. M. Bondy: None. S. Devaraj: None.

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