Vaspin is related to gender, puberty and deteriorating insulin sensitivity in children
Background: Visceral adipose tissue-derived serine protease inhibitor (vaspin) has been suggested as a novel adipocytokine related to obesity and insulin sensitivity in adults. Design: We quantified vaspin serum concentrations in 65 lean and 67 obese children and aimed to evaluate the relationship o...
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| Veröffentlicht in: | International Journal of Obesity 2011-04, Vol.35 (4), p.578-586 |
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| container_title | International Journal of Obesity |
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| creator | Korner, A Neef, M Friebe, D Erbs, S Kratzsch, J Dittrich, K Bluher, S Kapellen, T.M Kovacs, P Stumvoll, M Bluher, M Kless, W |
| description | Background: Visceral adipose tissue-derived serine protease inhibitor (vaspin) has been suggested as a novel adipocytokine related to obesity and insulin sensitivity in adults. Design: We quantified vaspin serum concentrations in 65 lean and 67 obese children and aimed to evaluate the relationship of vaspin with physical development, obesity, and metabolic and cardiovascular phenotypes in children. We further assessed the acute vaspin response to glucose provocation in 20 obese adolescents and evaluated tissue expression patterns of vaspin in humans. Results: Vaspin levels were significantly higher in girls than in boys. In girls, vaspin increased with age and pubertal stage, whereas there was no change with development in boys. Obese girls had lower vaspin serum levels than those of lean controls, but there was no significant correlation with body mass index (BMI). Independent of sex, age and BMI, lower vaspin was associated with better insulin sensitivity, with higher systolic blood pressure and impaired endothelial function. In response to glucose provocation during an oral glucose tolerance test, vaspin serum levels declined by approximately 25% in adolescents with hyperinsulinemia, whereas there was no significant decline in normoinsulinemic patients. In support of our clinical data, we not only confirmed vaspin mRNA expression in adipose tissue but also found consistent expression of vaspin in the liver and indications for expression in the pancreas and the skin. Conclusion: We showed that gender differences in circulating vaspin levels develop during pubertal progression in girls. Although vaspin's association with obesity remains controversial, vaspin was increased with worsening insulin resistance already in children and was acutely down-regulated following glucose provocation in insulin-resistant adolescents independent of obesity. Besides adipose tissue, vaspin expression in the liver and the pancreas may potentially contribute to circulating vaspin levels and their regulation. |
| doi_str_mv | 10.1038/ijo.2010.196 |
| format | Article |
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Design: We quantified vaspin serum concentrations in 65 lean and 67 obese children and aimed to evaluate the relationship of vaspin with physical development, obesity, and metabolic and cardiovascular phenotypes in children. We further assessed the acute vaspin response to glucose provocation in 20 obese adolescents and evaluated tissue expression patterns of vaspin in humans. Results: Vaspin levels were significantly higher in girls than in boys. In girls, vaspin increased with age and pubertal stage, whereas there was no change with development in boys. Obese girls had lower vaspin serum levels than those of lean controls, but there was no significant correlation with body mass index (BMI). Independent of sex, age and BMI, lower vaspin was associated with better insulin sensitivity, with higher systolic blood pressure and impaired endothelial function. In response to glucose provocation during an oral glucose tolerance test, vaspin serum levels declined by approximately 25% in adolescents with hyperinsulinemia, whereas there was no significant decline in normoinsulinemic patients. In support of our clinical data, we not only confirmed vaspin mRNA expression in adipose tissue but also found consistent expression of vaspin in the liver and indications for expression in the pancreas and the skin. Conclusion: We showed that gender differences in circulating vaspin levels develop during pubertal progression in girls. Although vaspin's association with obesity remains controversial, vaspin was increased with worsening insulin resistance already in children and was acutely down-regulated following glucose provocation in insulin-resistant adolescents independent of obesity. Besides adipose tissue, vaspin expression in the liver and the pancreas may potentially contribute to circulating vaspin levels and their regulation.</description><identifier>ISSN: 0307-0565</identifier><identifier>EISSN: 1476-5497</identifier><identifier>DOI: 10.1038/ijo.2010.196</identifier><identifier>PMID: 20856257</identifier><identifier>CODEN: IJOBDP</identifier><language>eng</language><publisher>London: Nature Publishing Group</publisher><subject>631/136 ; 631/443/319/1642 ; 692/700/1720 ; Adipose tissue ; Adipose tissues ; Adolescent ; Adolescents ; adults ; Biological and medical sciences ; Blood pressure ; blood serum ; Body Composition ; Body mass index ; boys ; Child ; Children ; Epidemiology ; Female ; Gender ; gender differences ; gene expression ; General aspects ; girls ; Glucose ; Glucose Tolerance Test ; glucose tolerance tests ; Health aspects ; Health Promotion and Disease Prevention ; Humans ; hyperinsulinemia ; Insulin resistance ; Insulin Resistance - physiology ; Internal Medicine ; Intra-Abdominal Fat - metabolism ; Intra-Abdominal Fat - physiopathology ; Liver ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; messenger RNA ; Metabolic Diseases ; Obesity ; Obesity - metabolism ; Obesity - physiopathology ; original-article ; pancreas ; patients ; phenotype ; Physiological aspects ; Protease inhibitors ; Proteinase inhibitors ; puberty ; Puberty - metabolism ; Public Health ; Risk factors ; serine proteinases ; Serpins - blood ; Serpins - physiology ; Sex Characteristics ; systolic blood pressure ; Teenagers</subject><ispartof>International Journal of Obesity, 2011-04, Vol.35 (4), p.578-586</ispartof><rights>Macmillan Publishers Limited 2011</rights><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2011 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group Apr 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c539t-d18fb42e415b242edb526e29d68253d2c047ce6e514ab42523f979300f766b8e3</citedby><cites>FETCH-LOGICAL-c539t-d18fb42e415b242edb526e29d68253d2c047ce6e514ab42523f979300f766b8e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/ijo.2010.196$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/ijo.2010.196$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24060262$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20856257$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Korner, A</creatorcontrib><creatorcontrib>Neef, M</creatorcontrib><creatorcontrib>Friebe, D</creatorcontrib><creatorcontrib>Erbs, S</creatorcontrib><creatorcontrib>Kratzsch, J</creatorcontrib><creatorcontrib>Dittrich, K</creatorcontrib><creatorcontrib>Bluher, S</creatorcontrib><creatorcontrib>Kapellen, T.M</creatorcontrib><creatorcontrib>Kovacs, P</creatorcontrib><creatorcontrib>Stumvoll, M</creatorcontrib><creatorcontrib>Bluher, M</creatorcontrib><creatorcontrib>Kless, W</creatorcontrib><title>Vaspin is related to gender, puberty and deteriorating insulin sensitivity in children</title><title>International Journal of Obesity</title><addtitle>Int J Obes</addtitle><addtitle>Int J Obes (Lond)</addtitle><description>Background: Visceral adipose tissue-derived serine protease inhibitor (vaspin) has been suggested as a novel adipocytokine related to obesity and insulin sensitivity in adults. Design: We quantified vaspin serum concentrations in 65 lean and 67 obese children and aimed to evaluate the relationship of vaspin with physical development, obesity, and metabolic and cardiovascular phenotypes in children. We further assessed the acute vaspin response to glucose provocation in 20 obese adolescents and evaluated tissue expression patterns of vaspin in humans. Results: Vaspin levels were significantly higher in girls than in boys. In girls, vaspin increased with age and pubertal stage, whereas there was no change with development in boys. Obese girls had lower vaspin serum levels than those of lean controls, but there was no significant correlation with body mass index (BMI). Independent of sex, age and BMI, lower vaspin was associated with better insulin sensitivity, with higher systolic blood pressure and impaired endothelial function. In response to glucose provocation during an oral glucose tolerance test, vaspin serum levels declined by approximately 25% in adolescents with hyperinsulinemia, whereas there was no significant decline in normoinsulinemic patients. In support of our clinical data, we not only confirmed vaspin mRNA expression in adipose tissue but also found consistent expression of vaspin in the liver and indications for expression in the pancreas and the skin. Conclusion: We showed that gender differences in circulating vaspin levels develop during pubertal progression in girls. Although vaspin's association with obesity remains controversial, vaspin was increased with worsening insulin resistance already in children and was acutely down-regulated following glucose provocation in insulin-resistant adolescents independent of obesity. Besides adipose tissue, vaspin expression in the liver and the pancreas may potentially contribute to circulating vaspin levels and their regulation.</description><subject>631/136</subject><subject>631/443/319/1642</subject><subject>692/700/1720</subject><subject>Adipose tissue</subject><subject>Adipose tissues</subject><subject>Adolescent</subject><subject>Adolescents</subject><subject>adults</subject><subject>Biological and medical sciences</subject><subject>Blood pressure</subject><subject>blood serum</subject><subject>Body Composition</subject><subject>Body mass index</subject><subject>boys</subject><subject>Child</subject><subject>Children</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Gender</subject><subject>gender differences</subject><subject>gene expression</subject><subject>General aspects</subject><subject>girls</subject><subject>Glucose</subject><subject>Glucose Tolerance Test</subject><subject>glucose tolerance tests</subject><subject>Health aspects</subject><subject>Health Promotion and Disease Prevention</subject><subject>Humans</subject><subject>hyperinsulinemia</subject><subject>Insulin resistance</subject><subject>Insulin Resistance - physiology</subject><subject>Internal Medicine</subject><subject>Intra-Abdominal Fat - metabolism</subject><subject>Intra-Abdominal Fat - physiopathology</subject><subject>Liver</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>messenger RNA</subject><subject>Metabolic Diseases</subject><subject>Obesity</subject><subject>Obesity - metabolism</subject><subject>Obesity - physiopathology</subject><subject>original-article</subject><subject>pancreas</subject><subject>patients</subject><subject>phenotype</subject><subject>Physiological aspects</subject><subject>Protease inhibitors</subject><subject>Proteinase inhibitors</subject><subject>puberty</subject><subject>Puberty - metabolism</subject><subject>Public Health</subject><subject>Risk factors</subject><subject>serine proteinases</subject><subject>Serpins - blood</subject><subject>Serpins - physiology</subject><subject>Sex Characteristics</subject><subject>systolic blood pressure</subject><subject>Teenagers</subject><issn>0307-0565</issn><issn>1476-5497</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqF0s1rFDEYB-BBFLtWb551UNRLZ813JsdS_IKCB22vITN5ZzfLbLImGaH_vRlmtVYUySEked43JPyq6ilGa4xo-9btwpqgeaXEvWqFmRQNZ0rer1aIItkgLvhJ9SilHUKIc0QeVicEtVwQLlfV9bVJB-drl-oIo8lg6xzqDXgL8aw-TB3EfFMbb2sLGaIL0WTnN7XzaRpLXQKfXHbfXVFl2W_daCP4x9WDwYwJnhzn0-rq_buvFx-by88fPl2cXzY9pyo3FrdDxwgwzDtSZttxIoAoK1rCqSU9YrIHARwzUxwndFBSUYQGKUTXAj2t3ix9DzF8myBlvXeph3E0HsKUdCsFIbRl6v9SYKkwRbN88YfchSn68owZUaUkYwW9XNDGjKCdH0KOpp9b6nPCmZAtx6So9V9UGRb2rg8eBlf27xS8_q1gC2bM2xTGKbvg0114tsA-hpQiDPoQ3d7EG42RnnOhSy70nAtdclH4s-Obpm4P9hf-GYQCXh2BSb0Zh2h879KtY0ggIuZ7m8WlcuQ3EG8_5x8XP1_8YII2m1h6Xn0pp7yEUVIsJf0B76zUlQ</recordid><startdate>20110401</startdate><enddate>20110401</enddate><creator>Korner, A</creator><creator>Neef, M</creator><creator>Friebe, D</creator><creator>Erbs, S</creator><creator>Kratzsch, J</creator><creator>Dittrich, K</creator><creator>Bluher, S</creator><creator>Kapellen, T.M</creator><creator>Kovacs, P</creator><creator>Stumvoll, M</creator><creator>Bluher, M</creator><creator>Kless, W</creator><general>Nature Publishing Group</general><general>Nature Publishing Group UK</general><scope>FBQ</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T2</scope><scope>7TK</scope><scope>7TS</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>7U2</scope></search><sort><creationdate>20110401</creationdate><title>Vaspin is related to gender, puberty and deteriorating insulin sensitivity in children</title><author>Korner, A ; Neef, M ; Friebe, D ; Erbs, S ; Kratzsch, J ; Dittrich, K ; Bluher, S ; Kapellen, T.M ; Kovacs, P ; Stumvoll, M ; Bluher, M ; Kless, W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c539t-d18fb42e415b242edb526e29d68253d2c047ce6e514ab42523f979300f766b8e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>631/136</topic><topic>631/443/319/1642</topic><topic>692/700/1720</topic><topic>Adipose tissue</topic><topic>Adipose tissues</topic><topic>Adolescent</topic><topic>Adolescents</topic><topic>adults</topic><topic>Biological and medical sciences</topic><topic>Blood pressure</topic><topic>blood serum</topic><topic>Body Composition</topic><topic>Body mass index</topic><topic>boys</topic><topic>Child</topic><topic>Children</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Gender</topic><topic>gender differences</topic><topic>gene expression</topic><topic>General aspects</topic><topic>girls</topic><topic>Glucose</topic><topic>Glucose Tolerance Test</topic><topic>glucose tolerance tests</topic><topic>Health aspects</topic><topic>Health Promotion and Disease Prevention</topic><topic>Humans</topic><topic>hyperinsulinemia</topic><topic>Insulin resistance</topic><topic>Insulin Resistance - physiology</topic><topic>Internal Medicine</topic><topic>Intra-Abdominal Fat - metabolism</topic><topic>Intra-Abdominal Fat - physiopathology</topic><topic>Liver</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>messenger RNA</topic><topic>Metabolic Diseases</topic><topic>Obesity</topic><topic>Obesity - metabolism</topic><topic>Obesity - physiopathology</topic><topic>original-article</topic><topic>pancreas</topic><topic>patients</topic><topic>phenotype</topic><topic>Physiological aspects</topic><topic>Protease inhibitors</topic><topic>Proteinase inhibitors</topic><topic>puberty</topic><topic>Puberty - metabolism</topic><topic>Public Health</topic><topic>Risk factors</topic><topic>serine proteinases</topic><topic>Serpins - blood</topic><topic>Serpins - physiology</topic><topic>Sex Characteristics</topic><topic>systolic blood pressure</topic><topic>Teenagers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Korner, A</creatorcontrib><creatorcontrib>Neef, M</creatorcontrib><creatorcontrib>Friebe, D</creatorcontrib><creatorcontrib>Erbs, S</creatorcontrib><creatorcontrib>Kratzsch, J</creatorcontrib><creatorcontrib>Dittrich, K</creatorcontrib><creatorcontrib>Bluher, S</creatorcontrib><creatorcontrib>Kapellen, T.M</creatorcontrib><creatorcontrib>Kovacs, P</creatorcontrib><creatorcontrib>Stumvoll, M</creatorcontrib><creatorcontrib>Bluher, M</creatorcontrib><creatorcontrib>Kless, W</creatorcontrib><collection>AGRIS</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database (Proquest)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Agriculture & Environmental Science Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biological Sciences</collection><collection>Agriculture Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Psychology Database (ProQuest)</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Safety Science and Risk</collection><jtitle>International Journal of Obesity</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Korner, A</au><au>Neef, M</au><au>Friebe, D</au><au>Erbs, S</au><au>Kratzsch, J</au><au>Dittrich, K</au><au>Bluher, S</au><au>Kapellen, T.M</au><au>Kovacs, P</au><au>Stumvoll, M</au><au>Bluher, M</au><au>Kless, W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vaspin is related to gender, puberty and deteriorating insulin sensitivity in children</atitle><jtitle>International Journal of Obesity</jtitle><stitle>Int J Obes</stitle><addtitle>Int J Obes (Lond)</addtitle><date>2011-04-01</date><risdate>2011</risdate><volume>35</volume><issue>4</issue><spage>578</spage><epage>586</epage><pages>578-586</pages><issn>0307-0565</issn><eissn>1476-5497</eissn><coden>IJOBDP</coden><abstract>Background: Visceral adipose tissue-derived serine protease inhibitor (vaspin) has been suggested as a novel adipocytokine related to obesity and insulin sensitivity in adults. Design: We quantified vaspin serum concentrations in 65 lean and 67 obese children and aimed to evaluate the relationship of vaspin with physical development, obesity, and metabolic and cardiovascular phenotypes in children. We further assessed the acute vaspin response to glucose provocation in 20 obese adolescents and evaluated tissue expression patterns of vaspin in humans. Results: Vaspin levels were significantly higher in girls than in boys. In girls, vaspin increased with age and pubertal stage, whereas there was no change with development in boys. Obese girls had lower vaspin serum levels than those of lean controls, but there was no significant correlation with body mass index (BMI). Independent of sex, age and BMI, lower vaspin was associated with better insulin sensitivity, with higher systolic blood pressure and impaired endothelial function. In response to glucose provocation during an oral glucose tolerance test, vaspin serum levels declined by approximately 25% in adolescents with hyperinsulinemia, whereas there was no significant decline in normoinsulinemic patients. In support of our clinical data, we not only confirmed vaspin mRNA expression in adipose tissue but also found consistent expression of vaspin in the liver and indications for expression in the pancreas and the skin. Conclusion: We showed that gender differences in circulating vaspin levels develop during pubertal progression in girls. Although vaspin's association with obesity remains controversial, vaspin was increased with worsening insulin resistance already in children and was acutely down-regulated following glucose provocation in insulin-resistant adolescents independent of obesity. Besides adipose tissue, vaspin expression in the liver and the pancreas may potentially contribute to circulating vaspin levels and their regulation.</abstract><cop>London</cop><pub>Nature Publishing Group</pub><pmid>20856257</pmid><doi>10.1038/ijo.2010.196</doi><tpages>9</tpages></addata></record> |
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| subjects | 631/136 631/443/319/1642 692/700/1720 Adipose tissue Adipose tissues Adolescent Adolescents adults Biological and medical sciences Blood pressure blood serum Body Composition Body mass index boys Child Children Epidemiology Female Gender gender differences gene expression General aspects girls Glucose Glucose Tolerance Test glucose tolerance tests Health aspects Health Promotion and Disease Prevention Humans hyperinsulinemia Insulin resistance Insulin Resistance - physiology Internal Medicine Intra-Abdominal Fat - metabolism Intra-Abdominal Fat - physiopathology Liver Male Medical sciences Medicine Medicine & Public Health messenger RNA Metabolic Diseases Obesity Obesity - metabolism Obesity - physiopathology original-article pancreas patients phenotype Physiological aspects Protease inhibitors Proteinase inhibitors puberty Puberty - metabolism Public Health Risk factors serine proteinases Serpins - blood Serpins - physiology Sex Characteristics systolic blood pressure Teenagers |
| title | Vaspin is related to gender, puberty and deteriorating insulin sensitivity in children |
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