Article Text

  1. M. V. Louthan1,
  2. J. Sullivan1,
  3. S. Joshi-Barve2,
  4. C. McClain3,4
  1. 1University of Louisville, Department of Pediatrics, Division of Gastroenterology, Department of Pediatrics, Division of Gastroenterology,and
  2. 2Division of Critical Care,
  3. 3University of Louisville
  4. 4Louisville VAMC


Background Despite increased prevalence of obesity in African-American children, a lower prevalence of obesity associated pediatric nonalcoholic fatty liver disease (NAFLD) has been found compared to Caucasian and Hispanic children. Adiponectin, an important adipocyte secreted anti-inflammatory adipocytokine has been shown to be deficient in children with NAFLD and some adult studies have suggested racial variations in adiponectin levels.

Objective To evaluate the relationship of adiponectin and race in obese children with and without NAFLD.

Methods 12 African American (4 girls/8 boys) and 15 Caucasian (5 girls/10 boys) overweight (BMI>85th% for age and gender) children (including 8 with NAFLD) were enrolled into an ongoing study on pediatric NAFLD. Children were evaluated at a fasting am visit at a pediatric research unit with anthropomorphic measurements and serum fasting insulin, glucose, ALT and adiponectin levels.

Results Mean adiponectin, insulin, glucose and BMI Z score were similar for boys and girls for both African Americans and Caucasians. For all subjects, BMI Z score had a significant negative correlation with adiponectin (r = -.45, p = .02). Overweight African American children had significantly lower mean adiponectin compared to Caucasian children (p<.05) despite similar BMI Z score. In addition, while the overweight Caucasian children had a significant negative correlation of adiponectin to fasting insulin (r = [199}.89, p<.001) as well as to fasting glucose (r = [199}.78, p<.001), these correlations were not seen in the African American children. ALT negatively correlated with adiponectin in the Caucasian children; however this did not reach statistical significance (r = -.479, p = .07).

Conclusions Significant differences in adiponectin and its relationship to insulin and glucose exist between African American and Caucasian children. Adiponectin, which is known to be decreased in pediatric NAFLD, is significantly related to insulin and glucose in Caucasian children, but not in African American children. This difference may help explain the increased prevalence of NAFLD in Caucasian children compared to African American children. Further investigation of the mechanism of adiponectin deficiency in NAFLD in Caucasian children is warranted.

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