Adiponectin may play a part in the pathogenesis of diabetic retinopathy

Abstract

Objectives: To measure plasma adiponectin concentrations in patients with type 2 diabetes and to investigate any association with the severity of diabetic retinopathy, because adiponectin seems to be an important modulator for metabolic and vascular diseases. Methods: Seventy-four patients (mean age 46.8^5.1 years; body mass index (BMI), 26.8^2.10 kg/m 2 ) and 54 healthy volunteers (mean age 46.8^5.4 years; BMI 26.47^2.33 kg/m 2 ) were included. Results: Adiponectin concentrations in the patients were significantly lower than those in controls (4.71^2.11 mg/ml for patients, n ¼ 74; 15.95^3.72 mg/ml for controls, n ¼ 54; P , 0.001). In the patients group there was a significant negative correlation between adiponectin and homeostasis model assessment index (r ¼ 2 0.318, P ¼ 0.006 respectively). Plasma adiponectin concentrations in patients with proliferative diabetic retinopathy (n ¼ 20; 3.16^1.83 mg/ml) or non-proliferative diabetic retinopathy (n ¼ 24; 3.97^1.47 mg/ml, P ¼ 0.014) were significantly lower than those in patients without diabetic retinopathy (n ¼ 30; 6.30^1.57 mg/ml, P ¼ 0.001). When the presence of diabetes was defined as the final variable in the conditional logistic regression model with the adiponectin concentration as the continuous variable, adiponectin was significantly involved in the model. Conclusion:The results show that adiponectin concentrations are lower in patients with type 2 diabetes and that the concentrations are associated with the severity of diabetic retinopathy. Our findings suggest that adiponectin may take part in the pathogenesis of diabetic retinopathy.

Increased serum adiponectin levels in type 1 diabetic patients with microvascular complications

“…However, we acknowledge that the number of normoalbuminuric patients with proliferative retinopathy was relatively small (19 out of 192 patients), and therefore this finding needs to be confirmed. Of note, a recent cross-sectional study in subjects with nearly normal weight and with sulphonylurea-treated type 2 diabetes reported a stepwise reduction in serum ADPN with increasing severity of retinopathy [19]. This contrasts with our findings in type 1 diabetes.…”

“…Clinically, lean patients with type 2 diabetes suffering from diabetic retinopathy (proliferative as well as non-proliferative) are reported to have lower levels of ADPN than matched patients without retinopathy [19]. On the other hand, lean as well as obese type 2 diabetic patients have normal to subnormal ADPN levels [19][20][21], whereas patients with type 1 diabetes have supranormal levels [22][23][24]. At the time of writing, there is sparse information on the association between serum ADPN and the presence of micro-and macrovascular complications in type 1 diabetes.…”

Diabetic retinopathy is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients

“…7 In fact, in a recent report demonstrating the association between DR, insulin resistance and adiponectin, the authors stressed the central role of endothelial dysfunction. 33 Second, DR may cause dysregulation of autonomic nervous system through an enhanced release of free fatty Abbreviations: BMI, body mass index; CI, confidence interval; E/A, the ratio of peak velocities of early to late ventricular filling; H/M ratio, heart-to-mediastinum ratio; HDL, high-density lipoprotein; HF, high-frequency; HOMA, homeostasis model assessment; LF/HF, ratio of LF to HF; LVMI, left ventricular mass index; NDR, no diabetic retinopathy; NS, not significant. Significant predictors of diabetic retinopathy were explored among three parameters: gender (female¼0, men¼1), hypertension (absent¼0, present¼1) and dyslipidemia (absent¼0, present¼1).…”

Obesity and Eye Diseases

“…204 Apart from leptin, other adipocytokines have also been investigated, but the evidence to support their roles in the pathogenesis of retinopathy is currently weak. 42,45,56,137,220 The impact of weight loss, particularly in obese individuals, on regression of retinopathy has been inadequately investigated. 174,195 Lifestyle changes, such as weight loss, has been advocated as a key factor in helping prevent diabetes and to delay diabetic complications including retinopathy in susceptible patients.…”