(P14-016-23) The Adiponectin Paradox Is Present in Children and Is Countered by Fruit and Vegetable Intake – The Arkansas Active Kids Study

Objectives: There is a direct association between adiponectin levels and mortality rate in heart failure patients. The underlying biology of this paradox is unknown. In adults, a diet rich in fruits and vegetables (FV) decreases cardiac strain. The purpose of this study was to evaluate the association of serum adiponectin concentration with markers of cardiac function (oxygen pulse, OP) and FV consumption in 7-to-10 year-old children.

Methods: Children (n=193) attended one study visit. Resting oxygen consumption (VO₂, ml/min) and heart rate (HR, bpm) were measured using a metabolic cart and a vital sign monitor, respectively. OP was used as surrogate of stroke volume and estimated as VO₂/HR (ml·O₂^-1·beat¹). Body composition was measured with DXA and fat-mass index z-scores (FMIZ) computed. FV consumption (cup/day) was estimated using questionnaires. Adiponectin (ng/ml) was measured from fasting serum. Generalized  linear regression analysis modeled the association of log-transformed serum adiponectin with OP, FV consumption, FMIZ, sex, age, and race.

Results: Children (9 y/o) were predominantly Caucasian (75%). After controlling for FMIZ, OP (β= -0.12, p= 0.001), age (β= -0.09, p= 0.027), Black race (β= -0.25, p=0.035), and male sex (β= -0.23, p =0.027) negatively associated adiponectin levels. FV consumption interacted with OP in relation to adiponectin levels (β= 0.10, p= 0.016). Final model: FV (β= -0.72, p= 0.012), OP (β= -0.28, p < 0.001), FV x OP interaction (β= 0.09, p =0.027), FMIZ (β= -0.25, p < 0.001), and Black race (β= -0.20, p= 0.08). Children were stratified as ‘Low-FV’ or ‘High-FV’ if their FV intake fell below or above the 1^st quartile (0.94) or 3^rd quartile (2.2), respectively. At the lowest end of OP, children in the ‘Low-FV’ group had higher adiponectin levels compared to children in the ‘High-FV’ group with similar OP. At the highest end of OP, children in the ‘Low-FV’ group had lower adiponectin levels compared to children in the ‘High-FV’ group with similar OP.

Conclusions: Adiponectin levels inversely associate with indirect measures of cardiac function in children. This association is modified by FV consumption. Our findings suggest the adiponectin paradox is also present in children. Increasing FV consumption is a feasible strategy to counter this phenomenon.

Funding Sources: USDA-ARS 3092-51000-056-04A, 6026-51000-012-06S; NIH-NIGMS 5P20GM109096.