The association between pentraxin 3 and insulin resistance in obese children at baseline and after physical activity intervention
Highlights
► We hypothesize that PTX3 may play a role in the development of insulin resistance in obese children. ► We performed cross-sectional study as well as intervention study to test our hypothesis. ► Cross-sectional study showed that PTX3 was negatively associated with insulin resistance. ► Delta PTX3 levels after the physical activity was associated with delta insulin resistance. ► PTX3 may play a role in the development of insulin resistance in obese children.
Introduction
Childhood obesity has increased significantly during the last decade and obesity associated with metabolic diseases such as cardiovascular disease and type 2 diabetes have become more prevalent among children [1], [2]. Inflammatory markers have been identified as one of main contributors for the development of obesity associated insulin resistance [3], [4], [5]. Exercise and physical activity are important to treat childhood obesity and obesity associated insulin resistance [6]. However, the exercise induced improvement of insulin resistance and its association with adipocytokines and/or inflammatory markers in children remained to be fully elucidated.
Pentraxin 3 (PTX3), a novel inflammatory marker, is a member of the long pentraxin family, a component of the humoral arm of innate immunity [7], [8]. Unlike the classic short pentraxin C-reactive protein (CRP), which is synthesized in the liver as a systemic response to local inflammation [9], PTX3 is produced rapidly in damaged tissue and may reflect more of a tissue-specific inflammatory response that includes smooth and skeletal muscle and adipocytes [10], [11], [12]. Although the role of PTX3 in the pathogenesis of atherosclerosis [13], [14] and heart failure [15] has been identified, studies still report conflicting data on the association of PTX3 with adiposity and insulin resistance in human among many different health conditions [14], [16], [17]. These conflicting reports on the relationship among PTX3, adiposity and insulin resistance could be due to the ages of the participants. Considering that PTX3 increases with the development of atherosclerosis, it might be more appropriate to investigate the relationship between PTX3, adiposity and insulin resistance in subjects without atherosclerosis but still have some degree of obesity [11], [13], [16]. Therefore, studying the relationship between PTX3 and obese children without atherosclerosis would be logical. In addition, most studies that reported an association between adiposity and circulating PTX3 levels have used body mass index (BMI) and waist circumference (WC) as an adiposity index. To completely understand the role of PTX3 in the development of obesity associated insulin resistance, the association of PTX3 with adiposity and insulin resistance should be investigated using more accurate adiposity measurements such as computed tomography (CT).
Physical activity decreases insulin resistance and also alters various adipocytokines including adiponectin, tumor necrosis factor-alpha and interleukin-6 [18], [19]. Fukuda et al. [20] and Nakajima et al. [21] recently reported changes in PTX3 levels after cardiac rehabilitation exercise and after high intensity aerobic and resistance exercise. However, the effects of exercise or short-term physical activity on PTX3 levels and its relationship to anthropometric, insulin resistance and metabolic parameters have not been studied. Therefore, the purpose of the study is to test whether 1) circulating PTX3 levels are associated with insulin resistance, anthropometric measurements and metabolic parameters and 2) whether 7 days of intense physical activity would alter PTX3 levels in association with changes in insulin resistance, anthropometric measurements and metabolic parameters.
Section snippets
Subject
Fifty‐seven overweight or obese elementary school students in the fourth, fifth or sixth grade participated in the study. All subjects were classified as either overweight or obese according to the criteria based on Korean Society for the Study of Obesity guidelines for children [22]. Subject characteristics are summarized in Table 1. This study was approved by the Institutional Ethics Review Board at Yonsei University College of Medicine, Wonju Campus. Written informed consent was obtained
PTX3 was not associated with adiposity but was significantly associated with whole body muscle mass and mid-thigh muscle mass (Fig. 1, Table 2)
There was no correlation between circulating PTX3 levels and any of the adiposity measurements including WC, percent body fat, VAT and SAT. However, there was a significant association between circulating PTX3 levels and whole body muscle mass and mid-thigh muscle mass. The association between circulating PTX3 and measurements of muscle mass remained statistically significant after controlling for gender, BMI and Tanner stage.
PTX3 was associated with plasma insulin levels, HOMA-IR and TG levels
Correlation coefficient analyses demonstrated that PTX3 levels were
Discussion
This reports the association between PTX3 and insulin resistance and the effects of short-term physical activity on circulating PTX3 levels and its association with insulin resistance in children. In the cross-sectional analyses, HOMA-IR was associated with PTX3 even after adjusting for age, gender, BMI and Tanner stage. Furthermore, the degree of changes in PTX3 levels were negatively associated with fasting and insulin and HOMA-IR, which provide evidence of the link between PTX3 and insulin
Disclosure statements
No author has anything to declare.
Acknowledgments
We appreciate Dr. Young Hee Lee and Mr. Sung Soo Jeon for their technical expertise and advice on measuring abdominal adiposity. This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2009‐0070217) and Sports ToTo.
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Both authors contributed equally to this work.