Relationship Between Adiponectin and Glycemic Control, Blood Lipids, and Inflammatory Markers in Men With Type 2 Diabetes

Abstract

OBJECTIVE -Adiponectin, synthesized in the adipose tissue, appears to play an important role in hyperglycemia and dyslipidemia, as well as in inflammatory mechanisms, which lead to a markedly increased atherosclerotic risk in diabetic subjects. However, previous studies did not evaluate the complex relationships between adiponectin and the array of metabolic abnormalities commonly observed in diabetes.RESEARCH DESIGN AND METHODS -To examine the associations between plasma levels of adiponectin and HbA 1c , blood lipids, and inflammatory markers, we obtained blood samples from 741 participants in the Health Professionals Follow-up Study with a diagnosis of type 2 diabetes.RESULTS -Plasma adiponectin levels were positively correlated with HDL cholesterol and negatively correlated with triglycerides, apolipoprotein B-100 (apoB 100 ), C-reactive protein (CRP), and fibrinogen. These associations were not appreciably altered after controlling for lifestyle exposures, medical conditions, and obesity-associated variables. A 10-g/ml higher level of plasma adiponectin was associated with lower HbA 1c (Ϫ0.21% points, P ϭ 0.001), triglycerides (Ϫ0.39 mmol/l, P Ͻ 0.001), apoB 100 (Ϫ0.04 g/l, P Ͻ 0.001), CRP (Ϫ0.51 mg/l, P ϭ 0.003), and fibrinogen (Ϫ0.53 mol/l, P Ͻ 0.001) and higher HDL cholesterol (0.13 mmol/l, P Ͻ 0.001). Associations between adiponectin and inflammatory markers were furthermore independent of HbA 1c and HDL cholesterol, suggesting that the anti-inflammatory properties of adiponectin are not mediated by potential effects on glycemic control and blood lipids. Our results were consistent among obese and nonobese men. CONCLUSIONS -Our study supports the hypothesis that increased adiponectin levels might be associated with better glycemic control, better lipid profile, and reduced inflammation in diabetic subjects. Measures that increase adiponectin levels might be valuable targets for decreasing the atherosclerotic risk present in diabetes. Diabetes Care 27:1680 -1687, 2004P atients with type 2 diabetes have a markedly increased atherosclerotic risk. The risk of fatal coronary heart disease among diabetic subjects is comparable with that observed in subjects who have had a previous myocardial infarction (1,2). This increased risk has been mainly attributed to hyperglycemia, dyslipidemia, and inflammatory mechanisms (3). Adiponectin, which is solely synthesized in the adipose tissue, appears to play an important role in all of these pathways (4). It has been found to be a major modulator of insulin action and resistance (5) and to predict the development of type 2 diabetes (6 -8). Furthermore, it seems to have substantial anti-inflammatory properties (4). Adiponectin is also related to lipid metabolism, particularly higher levels of HDL cholesterol, and lower levels of triglycerides (9). However, previous studies did not evaluate the complex relationships between adiponectin and the array of metabolic abnormalities commonly observed in diabetes. In particular, it remains unresolved whether the potential anti-in...

The role of total and high-molecular-weight complex of adiponectin in vascular function in offspring whose parents both had type 2 diabetes

“…Furthermore, we corroborated the strong relationship previously described between adiponectin and HDLcholesterol [13,47,48]. HDL-cholesterol is an important predictor of endothelial function [49][50][51][52][53].…”

Association of C-reactive protein with type 2 diabetes: prospective analysis and meta-analysis

“…The possibility of GGT and adiponectin being confounders is strengthened by previous observations of the association of these factors with CRP [15,25,26] and also with diabetes risk [19][20][21][22][23][24]. CRP originates in the liver and is increased in people with liver steatosis [32], suggesting a link between chronic inflammation and non-alcoholic fattyliver disease.…”

“…Plasma adiponectin levels are also inversely associated with CRP [25]. It is possible that adiponectin may act as an intermediate between CRP and diabetes.…”

“…Emerging evidence suggests that plasma concentrations of the adipocytokine adiponectin [19][20][21], and markers of liver injury, such as the hepatic enzyme γ-glutamyltransferase (GGT) [22][23][24] predict the development of type 2 diabetes, independently of traditional risk factors. Adiponectin and GGT are also associated with CRP levels [15,25,26]. To date, no published studies of the association between CRP and incident diabetes have considered these potentially important confounders.…”

Effect of nifedipine on adiponectin in hypertensive patients with type 2 diabetes mellitus

“…22,23 These data suggest that adiponectin has antiatherogenic properties, so that hypoadiponectinaemia might be associated with a higher incidence of vascular disease in diabetic subjects. 24 Nifedipine is a dihydropyridine calcium antagonist that improves endothelial function in patients with hypercholesterolaemia by enhancing NO activity, 25 and it also increases endothelial NO bioavailability by antioxidant mechanisms. 26 In addition, nifedipine influences platelet function and the activity of some chemokines, resulting in this drug showing an antiatherosclerotic effect in hyper-tensive patients with type 2 diabetes.…”