Serum adiponectin predicts all-cause mortality and end stage renal disease in patients with type I diabetes and diabetic nephropathy.
Adiponectin levels are increased in patients with type I diabetes especially in the presence of microangiopathy. Here we determined the predictive value of serum adiponectin levels and 8 adiponectin gene polymorphisms for mortality, cardiovascular events and end-stage renal disease in type I diabetic patients. This prospective, observational follow-up study of type I diabetics consisted of 438 patients with overt diabetic nephropathy that were compared to 440 type I patients with normal albumin excretion. These two groups were followed an average of 8 years and generally matched for gender, age and duration of diabetes. Cox regression analysis of 373 patients showed a covariate-adjusted hazard ratio for all-cause mortality of 1.46 for a change of one standard deviation in log10 of serum adiponectin. There was no association with cardiovascular events; however, serum adiponectin levels predicted end stage renal disease in a covariate-adjusted analysis. Two of eight gene polymorphisms, found in the 878 patients, were associated with increased serum adiponectin levels but none of the polymorphisms were associated with a renal or cardiovascular outcome. These studies show that high serum adiponectin levels predict mortality and progression to end stage renal disease in type I diabetic patients.
Jorsal
Anders
A
Steno Diabetes Center, Gentofte, Denmark. ajrs@steno.dk
Tarnow
Lise
L
Frystyk
Jan
J
Lajer
Maria
M
Flyvbjerg
Allan
A
Parving
Hans-Henrik
HH
Vionnet
Nathalie
N
Rossing
Peter
P
D052242:Adiponectin / Q000097:blood / Q000235:genetics; D000328:Adult; D000483:Alleles; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000235:genetics; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications / Q000235:genetics / Q000401:mortality; D003928:Diabetic Nephropathies / Q000097:blood* / Q000235:genetics / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D005787:Gene Frequency; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000209:etiology / Q000235:genetics / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D016016:Proportional Hazards Models; D011446:Prospective Studies
C499918:ADIPOQ protein, human; D052242:Adiponectin