Increased plasma adiponectin concentrations are associated with microangiopathy in type 1 diabetic subjects.
OBJECTIVE
Insulin resistance is related to an increased risk of diabetic retinopathy and nephropathy in type 1 diabetes. Patients with insulin resistance and/or macrovascular disease have abnormally low levels of adiponectin. The aim of this study was to investigate the relationships between adiponectin and renal and retinal diabetic complications in type 1 diabetic patients.


METHODS
In this 6-year prospective follow-up observational study, we evaluated the severity of retinopathy at baseline and determined the incident risk of microalbuminuria in 126 normoalbuminuric patients with type 1 diabetes. Each patient was age- and sex-matched to two non-diabetic control subjects.


RESULTS
Plasma adiponectin concentrations were significantly higher in diabetic subjects than in control subjects (p < 0.0001). The adiponectin concentration was significantly higher in patients with severe diabetic retinopathy than in those without (39.1+/-14.0 vs 29.0+/-13.0 microg/ml, p = 0.0005). The 18 patients who developed persistent microalbuminuria had higher adiponectin concentrations than the other patients (35.8+/-14.5 vs 30.6+/-13.7 microg/ml). Increased adiponectin concentrations were independently associated with the occurrence of microalbuminuria (p = 0.0158) after adjustment for baseline urinary albumin concentration (p = 0.004), sex (p = 0.0054), blood pressure (NS) and metabolic control (NS).


CONCLUSIONS
The elevated adiponectin concentrations observed in subjects with microvascular disease may indicate an altered regulation of this adipocytokine in patients with complications associated with type 1 diabetes.
Hadjadj
S
S
Department of Endocrinology and Diabetology, University Hospital, BP 577, 86021, Poitiers Cedex, France. s.hadjadj@chu-poitiers.fr
Aubert
R
R
Fumeron
F
F
Pean
F
F
Tichet
J
J
Roussel
R
R
Marre
M
M
D052242:Adiponectin; D000328:Adult; D000419:Albuminuria / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D003404:Creatinine / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D003925:Diabetic Angiopathies / Q000097:blood*; D003930:Diabetic Retinopathy / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D013997:Time Factors
D052242:Adiponectin; D015415:Biomarkers; D036341:Intercellular Signaling Peptides and Proteins; D003404:Creatinine