The prospective association between adiponectin and coronary artery disease among individuals with type 1 diabetes. The Pittsburgh Epidemiology of Diabetes Complications Study

Abstract

Aims/hypothesis: Recent findings suggest the potential involvement of adiponectin in obesity, diabetes and cardiovascular disease. We assessed the prospective association between adiponectin concentration and coronary artery disease in individuals with type 1 diabetes. Methods: Participants were identified from the Pittsburgh Epidemiology of Diabetes Complications cohort, a prospective follow-up study of childhood-onset type 1 diabetes. At baseline, subjects had a mean age of 28 years, and a mean diabetes duration of 19 years. Cases (deter mined by physician-diagnosed angina, confirmed myocardial infraction, stenosis ≥50%, ischemic ECG or revascularization) were matched to the control subjects with respect to sex, age and diabetes duration. Samples and risk factors for analyses were identified from the earliest exam prior to incidence in cases. Sera and information on all covariates were available for 28 cases and 34 control subjects. Proportional hazards models were constructed including matching variables. Results: Compared with those in men, adiponectin concentrations were elevated in females (p=0.009) and among individuals with macroalbuminuria (p=0.04). In multivariable analyses (adjusting for standard risk factors as well as lipoprotein measurements determined by nuclear magnetic resonance spectroscopy, E-selectin or antioxidants), adiponectin inversely predicted the incidence of coronary artery disease (hazard ratio=0.37 per 1 SD increase, 95% CI 0.19-0.73, p=0.004). Conclusions/interpretation: The results suggest that increased adiponectin concentration is prospectively associated with a lower risk of coronary artery disease type 1 diabetes. The potential of adiponectin determination as a useful marker of, and potential therapeutic target for, coronary artery disease prevention in type 1 diabetes should be further explored.

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.…”

“…So far, the results of studies are conflicting and several theories exist. The Pittsburgh Epidemiology of Complications Study, a prospective follow-up study, showed that adiponectin levels inversely predicted the incidence of CHD in type 1 diabetes (25). Adiponectin could prove a marker for cardiovascular disease in type 1 diabetes.…”

“…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). It needs to be clarified whether adiponectin plays an important role in the development of atherosclerosis in type 1 diabetes.…”

Lipoprotein particles, insulin, adiponectin, C-reactive protein and risk of coronary heart disease among men with metabolic syndrome

“…CRP as a measure of inflammation by high sensitivity CRP measurement (Dr. Russell Tracy, University of Vermont) (27) and measures of adiponectin (31,32) and insulin (33) at the Heinz Nutrition Laboratory at the University of Pittsburgh, Graduate School of Public Health (Dr. Rhobert Evans).…”