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Adiponectin, insulin resistance and clinical expression of the metabolic syndrome in patients with Type 2 diabetes.
Int J Obes (Lond). 2007 Feb; 31(2):213-20.IJ

Abstract

BACKGROUND

Obesity and the metabolic syndrome have emerged as clinical and public health crises in many populations, but not all obese patients have the syndrome. As adipocytes produce several adipokines that modulate insulin action as well as glucose and lipid metabolism, we postulate that estimation of adipokines may be useful addition to the criteria used to identify obese individuals with the metabolic syndrome.

OBJECTIVE

To evaluate the determinants and associations of plasma adiponectin in relation to the metabolic syndrome in patients with Type 2 diabetes.

DESIGN

Cross-sectional study.

SETTING

General Teaching Hospital.

PATIENTS

One hundred and thirty five (57 M, 78 F) patients with Type 2 diabetes mellitus.

MEASUREMENTS

Adiponectin, leptin, high-sensitivity C-reactive protein (hs-CRP), fasting plasma insulin, glucose, glycated hemoglobin and full lipid profile. Patients were classified on the basis of the degree of adiposity, insulin resistance (IR) (homeostasis model assessment of insulin resistance (HOMA-IR)) and the number of the American Heart Association and the National Heart, Lung and Blood Institute criteria of the metabolic syndrome.

RESULTS

Adiponectin levels were inversely correlated with age, indices of obesity, IR and hs-CRP. Overweight/obese and non-obese insulin-sensitive patients had significantly higher (P<0.05) adiponectin levels than those with IR despite similar body mass index and waist circumference. Therefore, within each category of obesity stratification, lower adiponectin levels were associated with IR. Adiponectin showed stepwise decrease with increasing number of the criteria for diagnosis of the metabolic syndrome. Using multiple logistic regression, the odds ratio of the metabolic syndrome as predicted by adiponectin was 0.73 (95% confidence interval 0.53-0.96; P=0.04). At cutoff point of 18 ng/ml, the diagnostic sensitivity and specificity of adiponectin for the metabolic syndrome were 83 and 65%, respectively, in male patients and 92 and 41%, respectively, in female patients. Receiver operating characteristic analysis showed that adiponectin had significantly higher area under the curve compared with leptin, leptin:adiponectin ratio and triglycerides for the detection of the metabolic syndrome.

CONCLUSIONS

In patients with Type 2 diabetes, adiponectin concentrations are closely related to IR and the components of the metabolic syndrome. Adiponectin concentration may be a useful addition to the criteria used for identifying obese subjects with the metabolic syndrome.

Authors+Show Affiliations

Department of Pathology, Faculty of Medicine Kuwait University, Safat, Kuwait. segunade@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16755284

Citation

Mojiminiyi, O A., et al. "Adiponectin, Insulin Resistance and Clinical Expression of the Metabolic Syndrome in Patients With Type 2 Diabetes." International Journal of Obesity (2005), vol. 31, no. 2, 2007, pp. 213-20.
Mojiminiyi OA, Abdella NA, Al Arouj M, et al. Adiponectin, insulin resistance and clinical expression of the metabolic syndrome in patients with Type 2 diabetes. Int J Obes (Lond). 2007;31(2):213-20.
Mojiminiyi, O. A., Abdella, N. A., Al Arouj, M., & Ben Nakhi, A. (2007). Adiponectin, insulin resistance and clinical expression of the metabolic syndrome in patients with Type 2 diabetes. International Journal of Obesity (2005), 31(2), 213-20.
Mojiminiyi OA, et al. Adiponectin, Insulin Resistance and Clinical Expression of the Metabolic Syndrome in Patients With Type 2 Diabetes. Int J Obes (Lond). 2007;31(2):213-20. PubMed PMID: 16755284.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adiponectin, insulin resistance and clinical expression of the metabolic syndrome in patients with Type 2 diabetes. AU - Mojiminiyi,O A, AU - Abdella,N A, AU - Al Arouj,M, AU - Ben Nakhi,A, Y1 - 2006/06/06/ PY - 2006/6/7/pubmed PY - 2007/4/24/medline PY - 2006/6/7/entrez SP - 213 EP - 20 JF - International journal of obesity (2005) JO - Int J Obes (Lond) VL - 31 IS - 2 N2 - BACKGROUND: Obesity and the metabolic syndrome have emerged as clinical and public health crises in many populations, but not all obese patients have the syndrome. As adipocytes produce several adipokines that modulate insulin action as well as glucose and lipid metabolism, we postulate that estimation of adipokines may be useful addition to the criteria used to identify obese individuals with the metabolic syndrome. OBJECTIVE: To evaluate the determinants and associations of plasma adiponectin in relation to the metabolic syndrome in patients with Type 2 diabetes. DESIGN: Cross-sectional study. SETTING: General Teaching Hospital. PATIENTS: One hundred and thirty five (57 M, 78 F) patients with Type 2 diabetes mellitus. MEASUREMENTS: Adiponectin, leptin, high-sensitivity C-reactive protein (hs-CRP), fasting plasma insulin, glucose, glycated hemoglobin and full lipid profile. Patients were classified on the basis of the degree of adiposity, insulin resistance (IR) (homeostasis model assessment of insulin resistance (HOMA-IR)) and the number of the American Heart Association and the National Heart, Lung and Blood Institute criteria of the metabolic syndrome. RESULTS: Adiponectin levels were inversely correlated with age, indices of obesity, IR and hs-CRP. Overweight/obese and non-obese insulin-sensitive patients had significantly higher (P<0.05) adiponectin levels than those with IR despite similar body mass index and waist circumference. Therefore, within each category of obesity stratification, lower adiponectin levels were associated with IR. Adiponectin showed stepwise decrease with increasing number of the criteria for diagnosis of the metabolic syndrome. Using multiple logistic regression, the odds ratio of the metabolic syndrome as predicted by adiponectin was 0.73 (95% confidence interval 0.53-0.96; P=0.04). At cutoff point of 18 ng/ml, the diagnostic sensitivity and specificity of adiponectin for the metabolic syndrome were 83 and 65%, respectively, in male patients and 92 and 41%, respectively, in female patients. Receiver operating characteristic analysis showed that adiponectin had significantly higher area under the curve compared with leptin, leptin:adiponectin ratio and triglycerides for the detection of the metabolic syndrome. CONCLUSIONS: In patients with Type 2 diabetes, adiponectin concentrations are closely related to IR and the components of the metabolic syndrome. Adiponectin concentration may be a useful addition to the criteria used for identifying obese subjects with the metabolic syndrome. SN - 0307-0565 UR - https://www.unboundmedicine.com/medline/citation/16755284/Adiponectin_insulin_resistance_and_clinical_expression_of_the_metabolic_syndrome_in_patients_with_Type_2_diabetes_ L2 - http://dx.doi.org/10.1038/sj.ijo.0803355 DB - PRIME DP - Unbound Medicine ER -