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Irisin and its relation to insulin resistance and puberty in obese children: a longitudinal analysis
Thomas Reinehr1, Clinton Elfers, Nina Lass
1Department of Pediatric Endocrinology, Diabetes, and Nutrition Medicine (T.R., N.L.), Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, D-45711 Datteln, Germany; and Seattle Children's Research Institute (C.E., C.L.R.), University of Washington, Seattle, Washington 98105.
Context:
Irisin is a recently identified myokine affecting metabolic and glucose homeostasis. However, the role of irisin in obesity and its metabolic consequences are controversial, and data in children are scarce.
Objective:
To study the relationships between irisin, insulin resistance, and puberty before and after weight loss in obese children with and without impaired glucose tolerance.
Design:
One-year follow-up study in obese children participating in a lifestyle intervention.
Setting:
Primary care.
Patients:
Forty obese children and 20 normal-weight children of similar age, gender, and pubertal stage.
Intervention:
A 1-year outpatient intervention program based on exercise, behavior, and nutrition therapy.
Main Outcomes Measures:
Fasting serum irisin, weight status (body mass index [BMI] SD score), and the following parameters of the metabolic syndrome: insulin resistance index (homeostasis model of assessment), blood pressure, and lipids.
Results:
The irisin levels were the highest in obese children with impaired glucose tolerance, followed by obese children with normal glucose tolerance, and levels were lowest in normal-weight children (P < .001). In a multiple linear regression analysis, baseline irisin was significantly associated with pubertal stage, high-density lipoprotein-cholesterol, and homeostasis model of assessment, but not to age, gender, BMI, or any other parameter of the metabolic syndrome. The irisin concentrations were significantly (P = .010) lower in the prepubertal compared to the pubertal children. In longitudinal analyses, changes of irisin were significantly associated with entry into puberty, change of fasting glucose, and 2-hour glucose in an oral glucose tolerance test, but not with change of BMI or any other parameter.
Conclusions:
Irisin levels are related to pubertal stage and insulin resistance but not to weight status in childhood.
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