Adiponectin and Leptin Concentrations May Aid in Discriminating Disease Forms in Children and Adolescents With Type 1 and Type 2 Diabetes

OBJECTIVE: The incidence of pediatric type 2 diabetes has recently seen an alarming increase. To improve our understanding of pediatric type 2 diabetes and identify markers that discriminate these subjects from those with type 1 diabetes, we performed a multivariant analysis associating serum adiponectin and leptin levels with anthropometrical parameters and disease state. RESEARCH DESIGN AND METHODS: Samples from children and adolescents with type 1 diabetes (n = 41) and type 2 diabetes (n = 17) and from nondiabetic individuals of similar age from the general population (n = 43) were investigated. An analysis included the parameters of matching for BMI and Tanner stage. Receiver-operator characteristic (ROC) curves were established to assess these analytes' association with disease. RESULTS: Contrary to studies of adult type 1 diabetes, adiponectin levels in our pediatric type 1 diabetic subjects (10.2 microg/ml 95% CI 8.6-11.7) did not differ from those of healthy control subjects (10.6 microg/ml 9.2-12.0; P = NS). Children with type 2 diabetes (5.5 microg/ml 4.8-6.2) had significantly lower adiponectin levels than both of those groups. Conversely, type 2 diabetic subjects showed marked elevations in serum leptin concentrations (24.3 ng/ml 17.1-31.5) compared with healthy control subjects (2.7 ng/ml 1.3-4.1; P 85th percentile or who had Tanner stage 4 and 5. The evaluation of adiponectin-to-leptin ratios revealed a striking difference between children with type 1 diabetes (6.3 3.8-8.8) and type 2 diabetes (0.3 0.2-0.5; P < 0.001). CONCLUSIONS: In pediatric diabetes, where diagnosis of disease is often difficult, these studies suggest that the adiponectin-to-leptin ratio may provide additional help in the discrimination between type 1 and type 2 diabetes.