Title : The importance of adiponectin for the prevention of obesity in children
According to the World Health Organization (WHO), the prevalence of obesity and its metabolic complications, both in adults and infants has considerably increased in recent decades. This increase in pediatric adiposity has created a relevant public health problem, as there are comorbidities such as dyslipidemia, hypertension, glucose intolerance, and hepatic steatosis. In the long run, these overweight children may become obese adults with an increased risk to get cardiovascular diseases. The role of adipose tissue goes beyond the simple storage of lipids and energy supply by mobilizing free fatty acids during fasting, it is a complex endocrine organ characterized by the adipokines secretion, adipocyte hypertrophy and infiltration of macrophages predominantly of visceral adipose tissue, which unleash an imbalance in the synthesis of proinflammatory/anti-inflammatory adipokines, with a decrease in anti-inflammatory adipokines: adiponectin and omentin-1, causing a low-grade chronic inflammation that determines the fundamental mechanism in obesity. Adiponectin exerts its anti-inflammatory effects directly on the macrophage. It changes the polarization of macrophages from the M1, pro-inflammatory category, to the M2, anti-inflammatory category. In other words, it modulates the classically activated pro-inflammatory phenotype of macrophages (M1) to alternately activated macrophages (M2); it stimulates the expression of arginase-1 and IL-10; and it improves the ability of macrophages to eliminate apoptotic bodies early, which is crucial in the prevention of inflammation. There is a new protective function of Adiponectin against metabolic disorders and organic damage through T-cadherin that facilitates the exosomic release of inadequately folded proteins, controls cellular stress, decreases ceramide levels, and maintains cellular homeostasis. Another essential function of adiponectin is to protect cells from apoptosis induced by endoplasmic reticulum stress and the reduction of the inflammation in adipocytes, hepatocytes, endothelial cells, and pancreatic beta cells as it blocks mitochondrial apoptosis through the activation of the pathway of the protein kinase signal. Adiponectin is a potential biochemical biomarker in metabolic disorders since it modulates the pathogenesis of overweight and diabetes mellitus type 2, thus considered key to the creation of new therapeutic intervention and prevention of these pathologies.