Distribution of Adiponectin, Leptin, And Metabolic Correlates of Insulin Resistance: A Longitudinal Study in British Children; 1: Prepuberty (Earlybird 15) (Endocrinology and Metabolism) (Clinical Report‪)‬

A key issue surrounding the current global rise in the prevalence of type 2 diabetes (T2D) [5] is the progressively younger age at presentation (1-4). The emergence of T2D in youth has mirrored a rising prevalence of obesity, insulin resistance, and its associated risk factors during childhood and adolescence (5-11). Insulin resistance is known to play a key role in the pathogenesis of T2D (12) and related disorders (13). Thus, recognition of the insulin resistance syndrome in childhood is becoming increasingly important. In parallel with the rising prevalence of obesity, insulin resistance, and T2D in children, there is a widening appreciation of the role of adipokines as regulators of energy metabolism (14), links between obesity and insulin resistance (15-17), and potential markers of cardiovascular disease (18). Although children may be screened for insulin resistance on the basis of clinical features such as obesity, acanthosis nigricans, and family history, identification of the metabolic correlates of insulin resistance requires laboratory assessment. The interpretation of laboratory data, however, presents a dilemma well known to pediatricians. The application of adult reference intervals in this context is inappropriate, yet appropriate age- and sex-specific pediatric data for comparison are scanty (19, 20) owing to the practical and ethical problems associated with collecting blood from large numbers of apparently healthy children to generate traditional reference values.