Direct evidence of brown adipocytes in different fat depots in children.

Recent studies suggested the persistence of brown adipocytes in adult humans, as opposed to being exclusively present in infancy. In this study, we investigated the presence of brown-like adipocytes in adipose tissue (AT) samples of children and adolescents aged 0 to 18 years and evaluated the association with age, location, and obesity. For this, we analysed AT samples from 131 children and 23 adults by histological, immunohistochemical and expression analyses. We detected brown-like and UCP1 positive adipocytes in 10.3% of 87 lean children (aged 0.3 to 10.7 years) and in one overweight infant, whereas we did not find brown adipocytes in obese children or adults. In our samples, the brown-like adipocytes were interspersed within white AT of perirenal, visceral and also subcutaneous depots. Samples with brown-like adipocytes showed an increased expression of UCP1 (>200fold), PRDM16 (2.8fold), PGC1α and CIDEA while other brown/beige selective markers, such as PAT2, P2RX5, ZIC1, LHX8, TMEM26, HOXC9 and TBX1 were not significantly different between UCP1 positive and negative samples. We identified a positive correlation between UCP1 and PRDM16 within UCP1 positive samples, but not with any other brown/beige marker. In addition, we observed significantly increased PRDM16 and PAT2 expression in subcutaneous and visceral AT samples with high UCP1 expression in adults. Our data indicate that brown-like adipocytes are present well beyond infancy in subcutaneous depots of non-obese children. The presence was not restricted to typical perirenal locations, but they were also interspersed within WAT of visceral and subcutaneous depots.

Evidence of early alterations in adipose tissue biology and function and its association with obesity-related inflammation and insulin resistance in children.

Accumulation of fat mass in obesity may result from hypertrophy and/or hyperplasia and is frequently associated with adipose tissue (AT) dysfunction in adults. Here we assessed early alterations in AT biology and function by comprehensive experimental and clinical characterization of 171 AT samples from lean and obese children aged 0 to 18 years. We show an increase in adipocyte size and number in obese compared with lean children beginning in early childhood. These alterations in AT composition in obese children were accompanied by decreased basal lipolytic activity and significantly enhanced stromal vascular cell proliferation in vitro, potentially underlying the hypertrophy and hyperplasia seen in obese children, respectively. Furthermore, macrophage infiltration, including the formation of crown-like structures, was increased in AT of obese children from 6 years on and was associated with higher hs-CRP serum levels. Clinically, adipocyte hypertrophy was not only associated with leptin serum levels but was highly and independently correlated with HOMA-IR as a marker of insulin resistance in children. In summary, we show that adipocyte hypertrophy is linked to increased inflammation in AT in obese children, thereby providing evidence that obesity-associated AT dysfunction develops in early childhood and is related to insulin resistance.

Molecular characteristics of serum visfatin and differential detection by immunoassays.

CONTEXT: There are controversial results concerning the association of visfatin with obesity and diabetes. We aimed to characterize molecular features of visfatin, to assess visfatin detection by different immunoassays, and evaluate the association with human obesity and glucose metabolism. RESULTS: Distinct preparations of human visfatin (recombinant, endogenously expressed from human adipocytes, and overexpressed in COS-7 cells) were readily identified by three currently available immunoassays. However, direct comparison of native human serum samples did reveal great discrepancies between these assays and complete lack of correlation. To specify putative molecular isoforms of visfatin, we fractionated iodine-125-labeled recombinant visfatin spiked into human serum and supernatants of visfatin-overexpressing COS-7 cells by size exclusion chromatography. We obtained a distinct peak at approximately 100 kDa that was confirmed by subsequent Western blotting of the fractions and is equivalent to the molecular mass of the dimer. Only one of the immunoassays detected a similar peak in native human size exclusion chromatography serum fractions, whereas the others detected a peak at more than 500 kDa or did not show any distinct peak. We did not observe any differences in visfatin serum levels between lean or obese patients. In addition, there was no correlation between visfatin serum levels with visfatin mRNA expression in sc or visceral fat and with parameters of glucose metabolism. CONCLUSION: Differences in the qualitative and quantitative detection of visfatin by immunoassays need to be considered in clinical association studies and may explain the conflicting observations with respect to a putative relation of circulating visfatin to human obesity or insulin resistance.