Kwang Youn Kim; Jung Ae Hong; Ha Won Hwang; Sun Ho Lee; Ju Ri Park; Sung Hoon Yu; Jun Goo Kang; Ohk Hyun Ryu; Seong Jin Lee; Eun Gyung Hong; Doo-Man Kim; Jae Myung Yoo; Sung Hee Ihm; Moon Gi Choi; Hyung Joon Yoo; Chul Sik Kim

doi:10.12997/jla.2015.4.1.7

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Kim, Hong, Hwang, Lee, Park, Yu, Kang, Ryu, Lee, Hong, Kim, Yoo, Ihm, Choi, Yoo, and Kim: Effects of the Serum Adiponectin to Tumor Necrosis Factor-α (TNF-α) Ratio on Carotid Intima-Media Thickness in Newly Diagnosed Type 2 Diabetic Patients

Original Article

Journal of Lipid and Atherosclerosis 2015; 4(1): 7-15.

Published online: 30 June 2015

DOI: https://doi.org/10.12997/jla.2015.4.1.7

Effects of the Serum Adiponectin to Tumor Necrosis Factor-α (TNF-α) Ratio on Carotid Intima-Media Thickness in Newly Diagnosed Type 2 Diabetic Patients

Kwang Youn Kim, Jung Ae Hong, Ha Won Hwang, Sun Ho Lee, Ju Ri Park, Sung Hoon Yu, Jun Goo Kang, Ohk Hyun Ryu, Seong Jin Lee, Eun Gyung Hong, Doo-Man Kim, Jae Myung Yoo, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo, Chul Sik Kim

Division of Endocrinology, Department of Internal Medicine, College of Medicine, Hallym University, Korea.

Corresponding Author: Chul Sik Kim, Division of Endocrinology, Department of Internal Medicine, College of Medicine, Hallym University, 22, Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang-si, Gyeonggi-do 431-796, Korea. Tel: +82-31-386-2269, Fax: +82-31-380-2269, ironeat@gmail.com

Received 10 October 2013 Revised 30 April 2015 Accepted 15 May 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

Type 2 diabetes, a leading cause of cardiovascular disease, is well known for its association with accelerated atherosclerosis. Adiponectin and tumor necrosis factor - alpha (TNF-α), which are produced and secreted in adipose tissue, have been suggested as predictors for cardiovascular disease. However, little is known about the influence of adiponectin and TNF-α ratio on the progression of carotid atherosclerosis in newly diagnosed type 2 diabetic patients. This study was conducted to evaluate the influence of serum adiponectin/TNF-α levels on the progression of carotid atherosclerosis.

Methods

One hundred eleven newly diagnosed type 2 diabetes patients were enrolled. Anthropometric and biochemical data including serum adiponectin, TNF-α were measured for each participant. Also we measured carotid intima-media thickness (CIMT) at baseline and at 1 year follow-up (n=81). We finally examined the relationship among serum adiponectin over TNF-α levels (ADPN/TNF-α), baseline CIMT, and progression of CIMT at 1 year.

Results

ADPN/TNF-α negatively correlated with baseline CIMT (r=-0.231, p=0.025). Moreover, progression of CIMT was significant at 1 year (0.011±0.138 mm). There was a negative correlation between ADPN/TNF-α and progression of CIMT at 1 year (r=-0.172, p=0.038). In multiple regression analysis, age and HbA1c were found to be independent risk factors for baseline CIMT. However, only HbA1c was an independent risk factor for the progression of CIMT.

Conclusion

ADPN/TNF-α was negatively associated with baseline CIMT and the progression of CIMT at 1 year. Overall glycemic control is the most important factor in the progression of CIMT in patients with type 2 diabetes.

Keywords: Diabetes Mellitus, Type 2, Adiponectin, TNF-α, Carotid Atherosclerosis, Carotid Intima Media Thickness

Figures and Tables

Fig. 1

Correlation between serum adiponectin/TNF-α level (log transformed) and baseline CIMT. r=-0.231, p=0.025. TNF-α; Tumor necrosis factor-α, CIMT; carotid artery intima-media thickness

Fig. 2

Correlation between serum adiponectin/TNF-α level and progression of CIMT. r=-0.172, p=0.038. TNF-α; Tumor necrosis factor-α, CIMT; carotid artery intima-media thickness

Table 1

Baseline clinical and biochemical characteristics of the subjects according to progression of carotid intima-media thickness

Data are presented as mean±SD.

CIMT; carotid intima-media thickness, LDL; indicates low-density lipoprotein, HDL; high-density lipoprotein, HOMA-IR; homeostatic model assessment for insulin resistance, TNF-α; Tumor necrosis factor-α, DPP4; dipeptidyl peptidase-4, RAS; renin angiotensin system

Table 2

Differences in medication use in 1 year

DPP4; dipeptidyl peptidase-4, RAS; renin angiotensin system

Table 3

Multivariate logistic regression modeling for predictors of carotid artery intima-media thickness in type 2 diabetic patients

CIMT; carotid artery intima-media thickness, LDL-C; low density lipoprotein cholesterol, BMI; body mass index, WC; waist circumference, HOMA-IR; homeostatic model assessment for insulin resistance, HDL-C; high density lipoprotein cholesterol, TNF-α; Tumor necrosis factor-α

Table 4

Multivariate logistic regression modeling for predictors of progression of carotid artery intima-media thickness in type 2 diabetic patients

CIMT; carotid artery intima-media thickness, BMI; body mass index, WC; waist circumference, HOMA-IR; homeostatic model assessment for insulin resistance, HDL-C; high density lipoprotein cholesterol, LDL-C; low density lipoprotein cholesterol, TNF-α; Tumor necrosis factor-α

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