Purpose
To investigate the association of leptin, resistin, and tumour necrosis factor α (TNF‐α) with prognosis in type 2 diabetes (T2D).
Methods
Analysis included 284 T2D patients. Apart from routine laboratory parameters, baseline leptin, resistin, and TNF‐α concentrations were measured. Patients were followed for a median of 5.4 years. The primary endpoint was all‐cause death at follow‐up. The secondary endpoint was a composite of death, acute coronary syndrome, and stroke or transient ischemic attack.
Results
At baseline, median age was 68 years, and 48% of patients were female. Data on the primary endpoint were obtained for all patients: 32 (11%) died during follow‐up. Data on the secondary endpoint were available for 230 patients, of whom 45 (20%) reached the secondary endpoint. In univariate analyses, older age, heart failure, lower‐glomerular filtration rate, and higher resistin, TNF‐α and NT‐proBNP concentrations were predictors of the study endpoints. Of these variables, only resistin remained an independent predictor of both study endpoints in multivariate models. In receiver‐operating characteristic analysis, area under the curve for resistin was 0.7. Resistin concentration of greater than or equal to 11.4 ng/mL had sensitivity of 41% and specificity of 91% for prediction of death at follow‐up (Youden's index).
Conclusions
Higher resistin is associated with reduced survival in T2D, irrespectively of TNF‐α. Resistin concentration of above 11 ng/mL indicates T2D patients at an increased risk of unfavourable outcomes. Leptin was not a prognostic factor. These results suggest that in T2D, association of resistin with unfavourable outcomes might, at least in part, result from its pro‐inflammatory properties.