title: Low plasma adiponectin levels predict increased urinary albumin/creatinine ratio in type 2 diabetes patients.
abstract: BACKGROUND
  Experimental studies have shown that adiponectin has antiproteinuric and nephroprotective effects. The purpose of the study was to assess the value of plasma adiponectin as a predictor of proteinuria in type 2 diabetes (T2D) patients.
  
  
  METHODS
  In this one-year prospective follow-up study, we included T2D patients with positive visual test for microalbuminuria (Micral) and negative visual test for proteinuria. Exclusion criteria were: glomerular filtration ratio (GFR) < 30 ml/min, acute infection/inflammation, uncontrolled hypertension, and atherosclerotic complications. The main outcome measure was the change in urinary albumin/creatinine ratio (UACR) after 1 year follow-up (Δ UACR).
  
  
  RESULTS
  Fifty-six patients (66% males) completed the study. Their initial mean UACR was 81.58 ± 26.42 mg/g and mean GFR was 81.15 ± 3.96 ml/min. At baseline, simple regression disclosed significant correlations between UACR and plasma adiponectin (r = 0.54, P = 0.00002) and GFR (r = -0.28, P = 0.03); in multiple regression analysis, plasma adiponectin remained the only predictor of UACR (P = 0.00007). Baseline plasma adiponectin was significantly correlated to body mass index (r = -0.28, P = 0.04), waist circumference (r = -0.27, P = 0.05), HDL cholesterol (r = 0.35, P = 0.01), and LDL cholesterol (r = 0.27, P = 0.04). Baseline plasma adiponectin significantly correlated in simple (r = -0.38, P = 0.004) and multiple regression (P = 0.04) to Δ UACR. When patients were divided according to Δ UACR in nonprogressors (Δ UACR < 0) and progressors (Δ UACR > 0), logistic regression showed that baseline GFR (OR = 1.04, CI95%: 1.00-1.09, P = 0.04) and plasma adiponectin (OR = 1.16, CI95%: 1.02-1.32, P = 0.02) were the only factors that predicted whether the patient would be a progressor or not.
  
  
  CONCLUSIONS
  In T2D patients, lower plasma adiponectin levels seem to be predictive of increased UACR.
authors: Department of Nephrology, University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj Napoca, 3-5 Clinicilor Street, 400006 Cluj Napoca, Romania.
authors: I
authors: I
authors: Kacso
authors: A
authors: A
authors: Lenghel
authors: C I
authors: CI
authors: Bondor
authors: D
authors: D
authors: Moldovan
authors: C
authors: C
authors: Rusu
authors: C
authors: C
authors: Nita
authors: N
authors: N
authors: Hancu
authors: M
authors: M
authors: Gherman Caprioara
authors: G
authors: G
authors: Kacso
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000419:Albuminuria / Q000150:complications / Q000378:metabolism*; D015992:Body Mass Index; D003404:Creatinine / Q000097:blood* / Q000652:urine*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism*; D003928:Diabetic Nephropathies / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D052242:Adiponectin; D003404:Creatinine