Background and aims Concurrent with the rise of the incidence in obesity, metabolic syndrome (MS) is increasingly prevalent in obese adolescents. Adiponectin is a major regulator of glucose and lipid homeostasis. Decreased adiponectin levels may be linked to MS. We aimed to test the hypothesis that adiponectin would influence the risk of MS in obese adolescents independent of its insulin sensitizer properties.

Methods This study was a cross-sectional study of the risk factors for MS in obese adolescents. A total of 593 obese subjects aged 10–18 years were recruited. International Diabetes Federation (IDF) consensus was used to define MS. We measured anthropometric, serum biochemical variables, serum adiponectin levels, and biomarkers for insulin resistance. We evaluated the independent influence of the adiponectin level on MS after controlling for the effect of insulin resistance measured by HOMA-IR.

Results 83 (14%) had MS. Obese adolescents with MS had significantly higher HOMA-IR and lower adiponectin levels than obese adolescents without MS. The adiponectin levels decreased with increasing number of metabolic syndrome components present in obese adolescents (p < 0.001). In multivariate logistic regression analysis, MS was significantly associated with age, body mass index, HOMA-IR, and adiponectin. For every 1μg/mL decrease in serum adiponectin level, there was an increased risk of having MS with an odds ratio of 1.229 (95% confidence interval, 1.112 to 1.358, p < 0.001).

Conclusions Decreased serum adiponectin level is associated with an increased risk for MS independent of the effects of age, BMI, and insulin resistance in our population of obese Taiwanese adolescents.