They're still kids.

the established risk factors for cardiometabolic disease. However, the alarming increase in overweight and obesity in children and the trajectory and reach of related comorbidities such as cardiometabolic disease challenge us to identify potential modifiable pathways that will have sufficient impact to turn these around. In this context, this study is a step in the direction of identifying unique individual risk profiles for obesity related cardiometabolic disease. The direction and the findings of the present study should stimulate further prospective research to address the value of RBP4 and other adipokines as " biomarkers. " Interestingly, although RBP4 was originally characterized by DeWitt Goodman et al, it took more than 4 decades and his daughter, Elizabeth Goodman, 18 along with Barbara Kahn's group, to extend the studies on RBP4, to a critically important clinical population, black adolescents. The novel insights from this report by Goodman et al 18 are very important, but should not be considered as the end of scientific inquiry in this vast field of adipokines and their potential role in insulin resistance related to cardiometabolic disease in children. REFERENCES 1. Kanai M, Raz A, Goodman DS. Retinol-binding protein: the transport protein for vitamin A in human plasma. Retinoids and retinoid-binding protein expression in rat adipocytes. Differentiation-dependent expression of retinoid-binding proteins in BFC-1[beta] adipocytes. Identification of a regulatory SNP in the retinol binding protein 4 gene associated with type 2 diabetes in Mongolia. Retinol binding protein 4 as a candidate gene for type 2 diabetes and prediabetic intermediate traits. Shortcomings in methodology complicate measurements of serum retinol binding protein (RBP4) in insulin-resistant human subjects. of elevated serum retinol binding protein in obese children by lifestyle intervention: association with subclinical inflammation. MB. Serum retinol-binding protein 4 concentration and its ratio to serum retinol are associated with obesity and metabolic syndrome components in children. J Clin Endo-crinol Metab 2007;92:4359-65. 17. Reinehr T, Stoffel-Wagner B, Roth CL. Retinol-binding protein 4 and its relation to insulin resistance in obese children before and after weight loss. relationship of retinol binding protein 4 to changes in insulin resistance and cardiom-etabolic risk in overweight black Americans. et al. Retinol binding protein 4 expression in humans: relationship to insulin resistance, inflammation, and response to pioglitazone. T wo articles in this issue of The Journal are important reminders that health risk affecting all children may have an even greater impact on children and youth with chronic illnesses. Hofer …