Plasma adiponectin levels are associated with insulin sensitivity in stroke survivors.
OBJECTIVE
Adiponectin is an anti-inflammatory and insulin-sensitizing adipokine produced by adipose tissue. The purpose of this study was to determine the relationships between adiponectin and glucose metabolism in stroke survivors and to compare adiponectin levels between patients with stroke and nonstroke control subjects similar in age, sex, and body mass index.


METHODS
In all, 52 stroke survivors (35 men, 17 women) and 33 nonstroke control subjects (22 men, 11 women) had plasma adiponectin levels measured by RIA, an oral glucose tolerance test, and a peak oxygen consumption-graded treadmill test. Insulin resistance (IR) and insulin sensitivity were assessed using the homeostasis model assessment for IR (HOMA-IR) and insulin sensitivity index (ISI(M)).


RESULTS
Adiponectin levels were positively associated with age (r = 0.32, P < .05) and negatively associated with glucose homeostasis (fasting glucose: r = -0.42; insulin: r = -0.36; Glucose at (120 min): r = -0.39; HOMA-IR: r = -0.45; and ISI(M): r = 0.44, all P < .01) in stroke survivors. Adiponectin levels were significantly different among normal glucose-tolerant, impaired glucose-tolerant, and diabetic patients with stroke (11.1 +/- 0.99 v 9.56 +/- 0.99 v 5.75 +/- 1.55 ng/mL, P < .05). Adiponectin levels were 62% higher in patients with stroke than control subjects (9.29 +/- 0.62 v 5.80 +/- 0.40 ng/mL, P < .001) despite greater fasting insulin levels (81%) and 120-minute insulin (70%) in stroke survivors than control subjects (P < .05). HOMA-IR was 78% higher and ISI(M) was 81% lower in stroke survivors than control subjects (P < .05).


CONCLUSIONS
Plasma adiponectin levels are associated with age and insulin sensitivity but not adiposity in stroke survivors. The paradoxical finding that the more IR stroke survivors had higher adiponectin levels than more insulin-sensitive control subjects suggests that perhaps anti-inflammatory cytokines increase to counter an inflamed and IR state in stroke survivors.
Ryan
Alice S
AS
Department of Medicine, Division of Gerontology, University of Maryland School of Medicine, Baltimore, MD, USA. aryan@grecc.umaryland.edu
Macko
Richard F
RF
Peters
Matthew N
MN
Ivey
Frederick M
FM
Prior
Steven J
SJ
Joseph
Lyndon J
LJ
Hafer-Macko
Charlene E
CE
D052242:Adiponectin / Q000097:blood*; D000368:Aged; D000369:Aged, 80 and over; D015308:Anaerobic Threshold / Q000502:physiology; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D005080:Exercise Test; D005260:Female; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000097:blood / Q000378:metabolism*; D017741:Survivors
D052242:Adiponectin; D001786:Blood Glucose; D007328:Insulin