Increased plasma adiponectin concentrations are associated with microangiopathy in type 1 diabetic subjects

Abstract

Aims/hypothesis: Insulin resistance is related to an increased risk of diabetic retinopathy and nephropathy in type 1 diabetes. Patients with insulin resistance and/or macrovascular disease have abnormally low levels of adiponectin. The aim of this study was to investigate the relationships between adiponectin and renal and retinal diabetic complications in type 1 diabetic patients. Methods: In this 6-year prospective follow-up observational study, we evaluated the severity of retinopathy at baseline and determined the incident risk of microalbuminuria in 126 normoalbuminuric patients with type 1 diabetes. Each patient was age-and sex-matched to two non-diabetic control subjects. Results: Plasma adiponectin concentrations were significantly higher in diabetic subjects than in control subjects (p<0.0001). The adiponectin concentration was significantly higher in patients with severe diabetic retinopathy than in those without (39.1±14.0 vs 29.0±13.0 μg/ml, p=0.0005). The 18 patients who developed persistent microalbuminuria had higher adiponectin concentrations than the other patients (35.8±14.5 vs 30.6±13.7 μg/ml). Increased adiponectin concentrations were independently associated with the occurrence of microalbuminuria (p=0.0158) after adjustment for baseline urinary albumin concentration (p=0.004), sex (p=0.0054), blood pressure (NS) and metabolic control (NS). Conclusions/interpretation: The elevated adiponectin concentrations observed in subjects with microvascular disease may indicate an altered regulation of this adipocytokine in patients with complications associated with type 1 diabetes.

Elevated serum levels of adiponectin in children, adolescents and young adults with type 1 diabetes and the impact of age, gender, body mass index and metabolic control: a longitudinal study

“…This study has demonstrated, as have other studies in adults with type 1 diabetes (12,(23)(24)(25), that serum concentrations of adiponectin are elevated in children and adolescents with type 1 diabetes. In contrast to adults, studies in children and adolescents with type 1 diabetes show controversial results (26,27).…”

“…This observation is confirmed by the paediatric studies where gender differences were not seen either (26,27). In contrast, the published studies in adults report on higher levels of adiponectin in women (12,(23)(24)(25). However, the findings in this study regarding the differences between adiponectin levels in males and females during pubertal development suggest an influence of gender.…”

“…Over the last years, few studies examined serum levels of adiponectin in patients with type 1 diabetes. Unexpectedly, adults with type 1 diabetes had higher serum levels of adiponectin compared with healthy adults (12,23). Adiponectin serum levels were even higher in patients with microvascular complications (12,23,24).…”

“…Unexpectedly, adults with type 1 diabetes had higher serum levels of adiponectin compared with healthy adults (12,23). Adiponectin serum levels were even higher in patients with microvascular complications (12,23,24). The Pittsburgh Epidemiology of Diabetes Complications Study showed that adiponectin inversely predicted the incidence of coronary artery disease in adults with type 1 diabetes (25).…”

Type 1 Diabetes and Coronary Artery Disease

“…Future research might reasonably focus on genes not having a proatherogenic effect or those mildly associated with CAD in nondiabetic populations that become strongly "activated" in the diabetes milieu, e.g., genes associated with gluc o s e m e t a b o l i s m a n d / o r i n s u l i n resistance. Adiponectin would also be of particular interest, given the growing evidence that genetic variants of the APM1 gene (11391G/Ϫ11377G haplotype T45G, G276T) affect adiponectin levels and are associated with cardiovascular risk in type 2 diabetes and nondiabetic control subjects (124 -126) and nephropathy in type 1 diabetes (127).…”