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

Abstract

for the Diabetes Prevention Program* OBJECTIVE-To determine whether baseline adiponectin levels or intervention-associated change in adiponectin levels were independently associated with progression to diabetes in the Diabetes Prevention Program (DPP). RESEARCH DESIGN AND METHODS-Coxproportional hazards analysis was used to evaluate the contribution of adiponectin and treatment-related change in adiponectin to risk of progression to diabetes.RESULTS-Baseline adiponectin was a strong independent predictor of incident diabetes in all treatment groups (hazard ratio per ϳ3 g/ml higher level; 0.61 in the lifestyle , 0.76 in the metformin, and the 0.79 in placebo groups; all P Ͻ 0.001, P ϭ 0.13 comparing groups). Baseline differences in adiponectin between sexes and race/ethnicity groups were not reflected in differences in diabetes risk. DPP interventions increased adiponectin levels ([means Ϯ SE] 0.83 Ϯ 0.05 g/ml in the lifestyle group, 0.23 Ϯ 0.05 g/ml in the metformin group, and 0.10 Ϯ 0.05 g/ml in the placebo group; P Ͻ 0.001 for increases versus baseline, P Ͻ 0.01 comparing groups). These increases were associated with reductions in diabetes incidence independent of baseline adiponectin levels in the lifestyle and placebo groups but not in the metformin subjects (hazard ratio 0.72 in the lifestyle group (P Ͻ 0.001), 0.92 in the metformin group (P ϭ 0.18), and 0.89 in the placebo group; P ϭ 0.02 per ϳ1 g/ml increase, P ϭ 0.02 comparing groups). In the lifestyle group, adjusting for change in weight reduced, but did not remove, the effect of increased adiponectin.CONCLUSIONS-Adiponectin is a powerful marker of diabetes risk in subjects at high risk for diabetes, even after adjustment for weight. An increase in adiponectin in the lifestyle and placebo groups was associated with a reduction in diabetes risk. However, these changes in adiponectin were comparatively small and less strongly related to diabetes outcome than baseline adiponectin levels. 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 (1-4). In a number of case-control and cohort studies (1,5-15), 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. The measurement of adiponectin may therefore carry additional prognostic value for diabetes and heart disease beyond the currently recognized set of risk factors.Furthermore, in experimental studies in animal models exogenous adiponectin reversed insulin resistance (16) and protected against diet-induced insulin resistance (17). Impairing adiponectin production or adiponectin receptor function predisposed to impairments in metabolism (18 -20). These observations, together with the epidemiologic ...

The role of leptin/adiponectin ratio in metabolic syndrome and diabetes

“…These findings in Latinos are similar to those from studies of adiponectin in other minority ethnic/racial groups, in that adiponectin is lower in minority groups than White populations [77]. Ethnic and racial minority groups (including Latinos) participating in the Diabetes Prevention Program study were also reported to have lower baseline adiponectin levels than non-Latino White participants [75].…”

“…Although this observation has been attributed, at least in part, to a higher rate of obesity in Latinos [73], IR and DM2 are more prevalent in Latinos compared to whites even after controlling for weight differences [74,75]. Moreover, decreased adiponectin levels were found in Latino compared to non-Latino White patients with CVD risk.…”

Adiponectin and Bariatric Surgery: Associations With Diabetes and Cardiovascular Disease in the Swedish Obese Subjects Study

“…We and others found positive correlations of adiponectin levels with age (7), whereas few studies have investigated intraindividual changes of adiponectin over time (8,9) and their predictive value for disease outcomes (10)(11)(12)(13). Adiponectin levels increase concomitantly with weight loss due to lifestyle intervention or bariatric surgery (10,14), but it has not been investigated in detail whether changes in adiponectin are associated with the incidence of diabetes or cardiovascular events.…”

“…Adiponectin levels increase concomitantly with weight loss due to lifestyle intervention or bariatric surgery (10,14), but it has not been investigated in detail whether changes in adiponectin are associated with the incidence of diabetes or cardiovascular events.…”

Longitudinal trajectories of adiponectin and HDL-C levels over a 3-year survey within the anti-aging health checkup system at Tokai University Tokyo Hospital

“…Reports from a few intervention trials involving obese subjects with or without glucose intolerance revealed that both adiponectin and HDL-C were increased by intensive exercise and diet programs targeting 7% weight loss [27][28][29] . However, an increase in HDL-C was not observed through weight loss by only a hypocaloric, low-fat diet without exercise 30) , suggesting the importance of exercise for increasing both adiponectin and HDL-C.…”