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. 2015 Dec;16(8):600-5.
doi: 10.1111/pedi.12226. Epub 2014 Oct 8.

Elevated plasma pigment epithelium-derived factor in children with type 2 diabetes mellitus is attributable to obesity

Jeanie B Tryggestad  1 , Joshua J Wang  2   3 , Sarah X Zhang  2   3 , David M Thompson  4 , Kevin R Short  1
Affiliations

Elevated plasma pigment epithelium-derived factor in children with type 2 diabetes mellitus is attributable to obesity

Jeanie B Tryggestad et al. Pediatr Diabetes. 2015 Dec.

Abstract

Background: Pigment epithelium-derived factor (PEDF) is a member of the serpin family secreted by adipocytes. Plasma PEDF is increased in obese children and adults. Adults with type 2 diabetes mellitus (T2DM) have higher circulating PEDF but there are no reports in children with T2DM.

Objective: To compare PEDF concentration in children with T2DM to normal weight and obese children without T2DM and determine associations with anthropometric or serum factors.

Methods: Participants were 34 obese children with T2DM diagnosed by American Diabetes Association (ADA) criteria, 61 normal weight [body mass index (BMI) 25-75 percentile] and 63 obese (BMI ≥ 95 percentile) children of age 8-18 yr. Plasma PEDF was measured in fasting plasma samples. Anthropometric, serum, and body composition (dual-energy x-ray absorptiometry, DXA) data were obtained for each subject to identify potential predictor variables.

Results: PEDF was 55% higher (p = 0.001) in the T2DM group compared with normal weight children, but did not differ from obese children. In the T2DM group, fat mass and lean mass both individually predicted PEDF (r² = 0.22 and 0.17, p = 0.02 and p < 0.01, respectively). PEDF was positively correlated with homeostatic model assessment - insulin resistance (HOMA-IR) when all groups were combined (r² = 0.15, p<0.001).

Conclusions: Plasma PEDF was similar in the T2DM and obese groups, therefore, obesity, rather than diabetes, may account for the higher PEDF in children with T2DM compared with normal weight children. PEDF was positively associated with both lean mass and fat mass both of which may contribute to the circulating level of the protein, and potentially to PEDF's association with insulin resistance in obese children with and without diabetes.

Keywords: PEDF; T2DM; obesity.

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Figures

Fig. 1.
Fig. 1.
Pigment-epithelium derived factor (PEDF) in normal weight, obese, and type 2 diabetes mellitus (T2DM) children. Values are for mean ± SEM; *obese and T2DM greater than normal weight (p < 0.05).
Fig. 2.
Fig. 2.
Associations with pigment-epithelium derived factor (PEDF) in type 2 diabetes mellitus (T2DM) children. (A) Association of PEDF and fat mass; r2 = 0.22. (B) Association of PEDF and lean mass; r2 = 0.17.
Fig. 3.
Fig. 3.
Curvilinear association between pigment-epithelium derived factor (PEDF) and insulin in obese and type 2 diabetes mellitus (T2DM) children.
See this image and copyright information in PMC

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