Journal List > Korean Diabetes J > v.32(3) > 1002219

Park, Kim, Kim, Han, Park, Mok, Park, Lee, and Kim: Adiponectin Concentrations in Type 2 Diabetic Patients with or without Metabolic Syndrome

Abstract

Background

Adipocytes produce several adipokines that modulate insulin action as well as glucose and lipid metabolism. The aim of this study was to evaluate the relationship between serum adiponectin concentrations and metabolic syndrome (MS) in patients with type 2 diabetes mellitus.

Methods

This study included 127 type 2 diabetic patients (males 63, females 64). The subjects were divided into two groups as with or without metabolic syndrome (MS(+) or MS(-)). The MS was diagnosed by International Diabetes Federation. Serum adiponectin, leptin, fasting plasma insulin, glucose, glycated hemoglobin, lipid profile, white blood corpuscle (WBC), aspartate aminotransferase (AST), alanine aminotransferase (ALT), uric acid and C-reactive protein (CRP) were examined.

Results

Serum adiponectin concentrations were significantly lower in MS(+) than MS(-) (4.8 ± 2.4 µg/mL vs 7.6 ± 5.8 µg/mL, 7.6 ± 3.7 µg/mL vs 11.5 ± 7.2 µg/mL, P < 0.05 in males and females). After adjustment for age and body mass index (BMI), in MS (+), the serum levels of adiponectin correlated positively with high density lipoprotein - cholesterol (HDL-C) and negatively with height, body weight, ALT and CRP. In MS(-), the serum levels of adiponectin correlated positively with HDL-C and negatively with diastolic blood pressure (DBP), triglyceride and CRP. By multiple regression analysis, no parameters were independently correlated with serum adiponectin concentrations in MS(+), while DBP and HDL-C were independently related to serum adiponectin concentrations in MS(-).

Conclusion

Serum adiponectin concentrations were lower in type 2 diabetic patients with MS than without MS. There were no significant parameters related to decrease serum adiponectin concentrations in MS. But further study is needed to confirm this result.

Figures and Tables

Fig. 1
Serum adiponectin and leptin concectrations in type 2 diabetic patients with metabolic syndrome (MS(+)) and without metabolic syndrome (MS(-)). *P < 0.05 vs MS(-).
kdj-32-224-g001
Fig. 2
Serum adiponectin concentrations in subgroups of metabolic syndrome (MS) (panel A). MS(+) HT presents the subgroup of MS with raised blood pressure. MS(+) Dys presents the subgroup of MS with hypertriglyceridaemia and/or low HDL-cholesterol, MS(+) HT+Dys is the subgroup of MS with raised blood pressure and hypertriglyceridaemia and/or low HDL-cholesterol. The serum level of MS(-) was significantly increased than that of each subgroup in MS(+). *P < 0.05 vs MS(+). Serum adiponectin concentrations in MS(+) Dys subgroups (panel B). Dys (TG) presents the subgroup of MS with hypertriglyceridaemia. Dys (HDL) presents the subgroup of MS with low HDL-cholesterol. Dys (TG&HDL) presents the subgroup of MS with hypertriglyceridaemia and low HDL-cholesterol. The serum adiponectin concentrations of each subgroup in MS(+) Dys group were not significantly different between them.
kdj-32-224-g002
Table 1
Clinical, anthropometric and metabolic characteristics of type 2 diabetic Patients
kdj-32-224-i001

Data are expressed as means ± standard deviation. BMI, body mass inde; DBP, diastolic blood pressure; DM, diabetes mellitus; FBS, fasting blood glucose; HDL-C, high-density lipoprotein cholesterol; HOMA-IR, homeostasis model assessment of insulin resistance; LDL-C, low-density lipoprotein cholesterol; MS(+), with metabolic syndrome; MS(-), without metabolic syndrome; SBP, systolic blood pressure; TC, total cholesterol; TG, triglyceride; WC, waist circumference; NS, not significant.

Table 2
Characteristics of metabolic parameters in type 2 diabetic patients
kdj-32-224-i002

Data are expressed as means ± standard deviation. ALT, alanine aminotransferase; AST, aspartate aminotransferase; CRP, C-reactive protein; MS(+), with metabolic syndrome; MS(-), without metabolic syndrome; WBC, white blood corpuscle; NS, not significant.

Table 3
Simple correlation and partial correlation of serum adiponectin concentration with other parameters in type 2 diabetic patients
kdj-32-224-i003

BMI, body mass index; CRP, C-reactive protein HDL-C, high-density lipoprotein cholesterol; TG, triglyceride; WC, waist circumference NS, not significant.

Table 4
Simple correlation and partial correlation of serum adiponectin concentration in type 2 diabetic patients with and without metabolic syndrome
kdj-32-224-i004

ALT alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass inde; CRP, C-reactive protein; DBP, diastolic blood pressure; DM, diabetes mellitus; FBS, fasting blood glucose; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; MS(+), with metabolic syndrome; MS(-), without metabolic syndrome; SBP, systolic blood pressure; TG, triglyceride; WC, waist circumference; NS, not significant.

Table 5
Multiple linear regression analysis for fasting adiponectin concentrations
kdj-32-224-i005

DBP, diastolic blood pressure; DM, diabetes mellitus; MS(+), with metabolic syndrome; MS(-), without metabolicsyndrome; HDL-C, high-density lipoprotein cholesterol; DBP, diastolic blood pressure.

References

1. Ahima RS, Flier JS. Adipose tissue as an endocrine organ. Trends Endocrinol Metab. 2000. 11:327–332.
crossref
2. Shimomura I, Funahashi T, Takahashi M, Maeda K, Kotani K, Nakamura T, Yamashita S, Miura M, Fukuda Y, Takemura K, Tokunaga K, Matsuzawa Y. Enhanced expression of PAI-1 in visceral fat: possible contributor to vascular disease in obesity. Nat Med. 1996. 2:800–803.
3. Spiegelman BM, Flier JS. Adipogenesis and obesity: rounding out the big picture. Cell. 1996. 87:377–389.
crossref
4. Tsao TS, Murrey HE, Hug C, Lee DH, Lodish HF. Oligomerization state-dependent activation of NF-kappa B signaling pathway by adipocyte complement-related protein of 30 kDa (Acrp30). J Biol Chem. 2002. 277:29359–29362.
5. Krakoff J, Funahashi T, Stehouwer CD, Schalkwijk CG, Tanaka S, Matsuzawa Y, Kobes S, Tataranni PA, Hanson RL, Knowler WC, Lindsay RS. Inflammatory markers, adiponectin, and risk of type 2 diabetes in the Pima Indian. Diabetes Care. 2003. 26:1745–1751.
crossref
6. Weyer C, Funahashi T, Tanaka S, Hotta K, Matsuzawa Y, Pratley RE, Tataranni PA. Hypoadiponectinemia in obesity and type 2 diabetes: close association with insulin resistance and hyperinsulinemia. J Clin Endocrinol Metab. 2001. 86:1930–1935.
crossref
7. Cnop M, Havel PJ, Utzschneider KM, Sinha MK, Boyko EJ, Retzlaff BM, Knopp RH, Brunzell JD, Kahn SE. Relationship of adiponectin to body fat distribution, insulin sensitivity and plasma lipoproteins: evidence for independent roles of age and sex. Diabetologia. 2003. 46:459–469.
crossref
9. Hotta K, Funahashi T, Arita Y, Takahashi M, Matsuda M, Okamoto Y, Iwahashi H, Kuriyama H, Ouchi N, Maeda K, Nishida M, Kihara S, Sakai N, Nakajima T, Hasegawa K, Muraguchi M, Ohmoto Y, Nakamura T, Yamashita S, Hanafusa T, Matsuzawa Y. Plasma concentrations of a novel, adipose-specific protein, adiponectin, in type 2 diabetic patients. Arterioscler Thromb Vasc Biol. 2000. 20:1595–1599.
crossref
11. Choi KM, Ryu OH, Lee KW, Kim HY, Seo JA, Kim SG, Kim NH, Choi DS, Baik SH. Serum adiponectin, interleukin-10 levels and inflammatory markers in the metabolic syndrome. Diabetes Res Clin Pract. 2007. 75:235–240.
crossref
12. Kim SM, Cho KH, Park HS. Relationship between plasma adiponectin levels and the metabolic syndrome. Endocr J. 2006. 53:247–254.
13. Jang Y, Lee JH, Kim OY, Koh SJ, Chae JS, Woo JH, Cho H, Lee JE, Ordovas JM. The SNP276G>T polymorphism in the adiponectin (ACDC) gene is more strongly associated with insulin resistance and cardiovascular disease risk than SNP45T>G in nonobese/nondiabetic Korean men independent of abdominal adiposity and circulating plasma adiponectin. Metabolism. 2006. 55:59–66.
14. Choi KM, Lee J, Lee KW, Seo JA, Oh JH, Kim SG, Kim NH, Choi DS, Baik SH. Serum adiponectin concentrations predict the developments of type 2 diabetes and the metabolic syndrome in elderly Koreans. Clin Endocrinol. 2004. 61:75–80.
crossref
15. Cruz M, Garcia-Macedo R, Garcia-Valerio Y, Gutierrez M, Medina-Navarro R, Duran G, Wacher N, Kumate J. Low adiponectin levels predict type 2 diabetes in Mexican children. Diabetes Care. 2004. 27:1451–1453.
crossref
16. Yamamoto Y, Hirose H, Saito I, Nishikai K, Saruta T. Adiponectin, an adipocyte-derived protein, predicts future insulin resistance: two year follow-up study in Japanese population. J Clin Endocrinol Metab. 2004. 89:87–90.
17. HOMA Calculator v2.2. Diabetes Trials Unit, Oxford, URL. 2004. accessed March 22 2005. http://www.dtu.ox.ac.uk/index.html/maindoc/publications/.
18. Friedewald WT, Levy RT, Fredrickson DS. Estimation of the concentration of low density lipoprotein cholesterol in plasma without use of the ultracentrifuge. Clin Chem. 1972. 18:449502.
19. The IDF consensus worldwide definition of the metabolic syndrome. International Diabetes Federation. 2005. 04. 14. accessed June 10, 2005. http://www.idf.org/webdata/docs/IDF_ Metasyndrome_definition.pdf.
20. Maeda N, Takahashi M, Funahashi T, Kihara S, Nishizawa H, Kishida K, Nagaretani H, Matsuda M, Komuro R, Ouchi N, Kuriyama H, Hotta K, Nakamura T, Shimomura I, Matsuzawa Y. PPARg ligands increase expression and plasma concentrations of adiponectin, an adipose-derived protein. Diabetes. 2001. 50:20949.
21. Fasshauer M, Klein J, Neumann S, Eszlinger M, Paschke R. Hormonal regulation of adiponectin gene expression in 3T3-L1adipocytes. Biochem Biophys Res Commun. 2002. 290:10849.
22. Halleux CM, Takahashi M, Delporte ML, Detry R, Funahashi T, Matsuzawa Y, Brichard SM. Secretion of adiponectin and regulation of apM1 gene expression in human visceral adipose tissue. Biochem Biophys Res Commun. 2001. 288:11027.
crossref
23. Motoshima H, Wu X, Sinha MK, Hardy VE, Rosato EL, Barbot DJ, Rosato FE, Goldstein BJ. Differential regulation of adiponectin secretion from cultured human omental and subcutaneous adipocytes: effects of insulin and rosiglitazone. J Clin Endocrinol Metab. 2002. 87:56627.
crossref
24. Yu JG, Javorschi S, Hevener AL, Kruszynska YT, Norman RA, Sinha M, Olefsky JM. The effect of thiazolidinediones on plasma adiponectin levels in normal, obese, and type 2 diabetic subjects. Diabetes. 2002. 51:296874.
crossref
25. Hulver MW, Zheng D, Tanner CJ, Houmard JA, Kraus WE, Slentz CA, Sinha MK, Pories WJ, MacDonald KG, Dohm GL. Adiponectin is not altered with exercise training despite enhanced insulin action. Am J Physiol Endocrinol Metab. 2002. 283:8615.
26. Abbasi F, Lamendola C, McLaughlin T, Hayden J, Reaven GM, Reaven PD. Plasma adiponectin concentrations do not increase in association with moderate weight loss in insulin resistant, obese women. Metabolism. 2004. 53:2803.
27. Fasshauer M, Klein J, Neumann S, Eszlinger M, Paschke R. Adiponectin gene expression is inhibited by beta-adrenergic stimulation via protein kinase A in 3T3-L1 adipocytes. FEBS Lett. 2001. 507:1426.
28. Fasshauer M, Kralisch S, Klier M, Lossner U, Bluher M, Klein J, Paschke R. Adiponectin gene expression and secretion is inhibited by interleukin-6 in 3T3-L1 adipocytes. Biochem Biophys Res Commun. 2003. 301:104550.
crossref
29. Kumada M, Kihara S, Sumitsuji S, Kawamoto T, Matsumoto S, Ouchi N, Arita Y, Okamoto Y, Shimomura I, Hiraoka H, Nakamura T, Funahashi T, Matsuzawa Y. Osaka CAD Study Group, Coronary artery disease. Association of hypoadiponectinemia with coronary artery disease in men. Arterioscler Thromb Vasc Biol. 2003. 23:85–89.
crossref
30. Mallamaci F, Zoccali C, Cuzzola F, Tripepi G, Cutrupi S, Parlongo S, Tanaka S, Ouchi N, Kihara S, Funahashi T, Matsuzawa Y. Adiponectin in essential hypertension. J Nephrol. 2002. 15:507–511.
31. Zoccali C, Mallamaci F, Tripepi G, Benedetto FA, Cutrupi S, Parlongo S, Malatino LS, Bonanno G, Seminara G, Rapisarda F, Fatuzzo P, Buemi M, Nicocia G, Tanaka S, Ouchi N, Kihara S, Funahashi T, Matsuzawa Y. Adiponectin, metabolic risk factors, and cardiovascular events among patients with end-stage renal disease. J Am Soc Nephrol. 2002. 13:134–141.
crossref
32. Kumada M, Kihara S, Ouchi N, Kobayashi H, Okamoto Y, Ohashi K, Maeda K, Nagaretani H, Kishida K, Maeda N, Nagasawa A, Funahashi T, Matsuzawa Y. Adiponectin specifically increased tissue inhibitor ofmetalloproteinase-1 through interleukin-10 expression in human macrophages. Circulation. 2004. 109:2046–2049.
33. Arita Y, Kihara S, Ouchi N, Maeda K, Kuriyama H, Okamoto Y, Kumada M, Hotta K, Nishida M, Takahashi M, Nakamura T, Shimomura I, Muraguchi M, Ohmoto Y, Funahashi T, Matsuzawa Y. Adipocyte derived plasma protein adiponectin acts as a platelet-derived growth factor-BB-binding protein and regulates growth factor-induced common postreceptor signal in vascular smooth muscle cell. Circulation. 2002. 105:2893–2898.
34. Matsubara M, Maruoka S, Katayose S. Decreased plasma adiponectin concentrations in women with dyslipidemia. J Clin Endocrinol Metab. 2002. 87:2764–2769.
crossref
35. Nishzawa T, Shimomura I, Kishida K, Maeda N, Kuriyama H, Nagaretani H, Matsuda M, Kondo H, Furuyama N, Kihara S, Nakamura T, Tochino Y, Furuyama N, Matsuzawa Y. Androgen decrease plasma adiponectin, an insulin sensitizing adipocyte derived protein. Diabetes. 2002. 51:2734–2741.
36. Arita Y, Kihara S, Ouchi N, Takahashi M, Maeda K, Miyagawa J, Hotta K, Shimomura I, Nakamura T, Miyaoka K, Kuriyama H, Nishida M, Yamashita S, Okubo K, Matsubara K, Muraguchi M, Ohmoto Y, Funahashi T, Matsuzawa Y. Paradoxical decrease of an adipose-specific protein, adiponectin, in obesity. Biochem Biophys Res Commun. 1999. 257:79–83.
crossref
37. Mojiminiyi OA, Abdella NA, Al Arouj M, Ben Nakhi A. Adiponectin, insulin resistance and clinical expression of the metabolic syndrome in patients with Type 2 diabetes. Int J Obes. 2007. 31:213–220.
crossref
TOOLS
Similar articles