Blockade of the renin-angiotensin system increases plasma adiponectin levels in type-2 diabetic patients with proteinuria.
OBJECTIVE
Adiponectin seems to be an important modulator for metabolic and vascular diseases. A case study was designed to measure plasma adiponectin levels and to investigate the effects of angiotensin-converting enzyme inhibitors on adiponectin levels in type-2 diabetic patients with proteinuria.


METHODS
Forty-nine patients (28 males, 21 females) and 23 healthy volunteers (13 males, 10 females) were included in the case study. Patients with proteinuria were treated with 5 mg/day ramipril (n = 21) for 4 weeks.


RESULTS
Adiponectin levels of patients were significantly lower than those of healthy volunteers (p < 0.001). There were significant negative correlations between adiponectin concentrations and insulin levels as well as the homeostasis model assessment (HOMA) index in the patient group (r = -0.655, p < 0.001; r = -0.469, p = 0.001, respectively). There was also a significant negative correlation between plasma adiponectin concentrations and the degree of proteinuria (r = -0.912, p < 0.001). Plasma adiponectin levels in patients with proteinuria (n = 21; 4.81 +/- 3.17 microg/ml) were significantly lower than those without proteinuria (n = 28; 10.25 +/- 2.03 microg/ml; p < 0.001). After the treatment period, adiponectin levels significantly increased (p < 0.001) and proteinuria, plasma insulin, and HOMA indexes significantly decreased in the treatment group (p < 0.001, p < 0.001, p = 0.002, respectively).


CONCLUSIONS
The results suggest that adiponectin is inversely correlated with proteinuria and treatment with ramipril both corrects proteinuria and increases the low adiponectin levels in diabetic patients.
Yenicesu
Müjdat
M
Department of Nephrology, Gulhane School of Medicine, Etlik-Ankara, Turkey.
Yilmaz
Mahmut Ilker
MI
Caglar
Kayser
K
Sonmez
Alper
A
Eyileten
Tayfun
T
Acikel
Cengizhan
C
Kilic
Selim
S
Bingol
Necati
N
Bingol
Sezin
S
Vural
Abdulgaffar
A
D052242:Adiponectin / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000097:blood* / Q000150:complications; D012084:Renin-Angiotensin System / Q000187:drug effects*
D052242:Adiponectin