Adiponectin and the development of diabetes in patients with coronary artery disease and impaired fasting glucose

Abstract

Objectives: Adiponectin has insulin-sensitizing properties, and high adiponectin levels have been shown to be associated with reduced risk of developing diabetes. Patients with coronary artery disease (CAD) have relatively low adiponectin levels and high prevalence of glucose intolerance. The role of adiponectin in predicting the development of diabetes in this high-risk group has not been determined. The study aimed to determine whether baseline adiponectin levels predict the development of diabetes in a group of patients with CAD and impaired fasting glucose (IFG). Methods: A total of 588 patients who participated in the Bezafibrate Infarction Prevention (BIP) study and who had at baseline fasting glucose of 100 -125 mg/dl were included and followed for 6.2^1.3 years. Adiponectin was determined in frozen plasma samples taken at baseline. Results: Of the patients with IFG at baseline, 256 (44%) developed diabetes during follow-up. The patients who developed diabetes had at baseline higher body-mass index, fasting glucose, C-reactive protein, triglycerides, homeostatic assessment of insulin resistance (HOMA-IR) and diastolic blood pressure than patients who did not develop diabetes. Adiponectin levels at baseline were significantly lower in patients who developed diabetes than in patients who did not develop diabetes (P ¼ 0.009, nonparametric Kruskall -Wallis test). An increase of 1 unit of natural logarithm of adiponectin level was associated with a hazard ratio of 0.77 (95% CI, 0.61-0.96) for diabetes development. Conclusion: Patients with CAD and IFG have a very high rate of conversion to type 2 diabetes. Even in this high-risk group, high adiponectin levels are associated with reduced risk of developing diabetes.European Journal of Endocrinology 154 87-92

Effects of Peroxisome Proliferator-Activated Receptor Ligands, Bezafibrate and Fenofibrate, on Adiponectin Level

“…26 Here we also showed that high baseline concentration of adiponectin was associated with lower risk for new-onset diabetes in patients with the MS. It should be noted that the randomly selected patients in the placebo and bezafibrate groups in our study present some minor differences regarding degree of obesity, insulin concentrations and use of angiotensin-converting enzyme inhibitors.…”

Adiponectin, Change in Adiponectin, and Progression to Diabetes in the Diabetes Prevention Program

“…Diabetes 57:980-986, 2008 A diponectin, the dominant secretory product of adipocytes, is a marker and perhaps a mediator of metabolic and cardiovascular disease risk (1)(2)(3)(4). In a number of case-control and cohort studies (1,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15), adiponectin levels have been found to be inversely associated with insulin sensitivity, conversion to diabetes, and risk of myocardial infarction. These associations remain significant after adjustment for baseline measures of obesity, suggesting that adiponectin reflects components of metabolic and vascular risk beyond those encompassed in obesity alone.…”

Insulin, leptin, and adiponectin receptors in colon: regulation relative to differing body adiposity independent of diet and in response to dimethylhydrazine

“…Although proposed as an abundant cytokine generated by adipose tissue, adiponectin, unlike leptin, is decreased with increased visceral obesity (21,52). Adiponectin is reported to be associated with improved insulin regulation, blood glucose, and triglyceride levels (28,42). Elevated leptin and insulin associated with obesity are correlated with lower adiponectin receptor expression, particularly in skeletal muscle and adipose tissue (14,52).…”