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Fetuin-A, adiposity-linked insulin resistance and responsiveness to an educational-based weight excess reduction program: a population-based survey in prepubertal schoolchildren

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Abstract

The secreted hepatokine fetuin-A emerges as an independent predictor of type 2 diabetes in adulthood. The overall aims of this study were: (1) to investigate the associations of fetuin-A with adiposity and insulin resistance, as well as its relationship with adipokines, in prepubertal children, and, (2) to evaluate whether, in prepubertal obesity, serum fetuin-A levels may either change or predict the responsiveness to an educational-based weight excess reduction program. We studied 200 prepubertal children (boys/girls: 89/111; Tanner stage 1; age: 5–13 years), included in a cohort of 44,231 adolescents who participated in an extensive Italian school-based survey. According to Cole’s criteria, 100 individuals were lean (boys/girls: 57/43) and 100 obese (boys/girls: 54/46). A subset of 53 obese individuals (boys/girls: 28/25; age: 6–12 years) were also evaluated after a weight excess reduction program. Serum fetuin-A, leptin, total and high molecular weight adiponectin levels, as well as homeostasis model assessment of insulin resistance were assessed. When compared with lean, obese children exhibited higher ( p < 0.0001) fetuin-A concentrations, without differences between sex. Fetuin-A was positively associated with adiposity, homeostasis model assessment of insulin resistance, and leptin levels. In multivariate analysis, the associations between fetuin-A and leptin or homeostasis model assessment of insulin resistance lost the significance after adjustment for BMI Z-score, which, in turn, represented an independent determinant of fetuin-A (R 2 adj 0.327; p < 0.0001). Notably, after weight excess reduction program, fetuin-A levels dropped ( p < 0.0001 vs. basal). Interestingly, no significant differences of fetuin-A concentrations between responders and no responders were found. In prepubertal children, fetuin-A represents an early marker of adiposity, and its reduction after lifestyle intervention may partly contribute to the beneficial effects of weight excess reduction program.

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Authors and Affiliations

  1. Department of Internal Medicine, Assisi Hospital, Assisi, Perugia, Italy

    Giuseppe Murdolo

  2. Department of Medicine, University of Perugia, Perugia, Italy

    Giuseppe Murdolo, Cristina Tortoioli, Vittorio Bini, Francesco Papi, Annalisa Brozzetti & Alberto Falorni

  3. Department of Pediatrics, Neonatology Intensive Care, Azienda Ospedaliera S. Maria, Terni, Italy

    Federica Celi

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  1. Giuseppe Murdolo
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  2. Cristina Tortoioli
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  4. Vittorio Bini
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Correspondence to Giuseppe Murdolo.

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Murdolo, G., Tortoioli, C., Celi, F. et al. Fetuin-A, adiposity-linked insulin resistance and responsiveness to an educational-based weight excess reduction program: a population-based survey in prepubertal schoolchildren. Endocrine 56, 357–365 (2017). https://doi.org/10.1007/s12020-016-1009-3

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