title: Combined use of serum adiponectin and tumor necrosis factor-alpha receptor 2 levels was comparable to 2-hour post-load glucose in diabetes prediction.
abstract: BACKGROUND
  Adipose tissue inflammation and dysregulated adipokine secretion are implicated in obesity-related insulin resistance and type 2 diabetes. We evaluated the use of serum adiponectin, an anti-inflammatory adipokine, and several proinflammatory adipokines, as biomarkers of diabetes risk and whether they add to traditional risk factors in diabetes prediction.
  
  
  METHODS
  We studied 1300 non-diabetic subjects from the prospective Hong Kong Cardiovascular Risk Factor Prevalence Study (CRISPS). Serum adiponectin, tumor necrosis factor-alpha receptor 2 (TNF-α R2), interleukin-6 (IL-6), adipocyte-fatty acid binding protein (A-FABP) and high-sensitivity C-reactive protein (hsCRP) were measured in baseline samples.
  
  
  RESULTS
  Seventy-six participants developed diabetes over 5.3 years (median). All five biomarkers significantly improved the log-likelihood of diabetes in a clinical diabetes prediction (CDP) model including age, sex, family history of diabetes, smoking, physical activity, hypertension, waist circumference, fasting glucose and dyslipidaemia. In ROC curve analysis, "adiponectin + TNF-α R2" improved the area under ROC curve (AUC) of the CDP model from 0.802 to 0.830 (P = 0.03), rendering its performance comparable to the "CDP + 2-hour post-OGTT glucose" model (AUC = 0.852, P = 0.30). A biomarker risk score, derived from the number of biomarkers predictive of diabetes (low adiponectin, high TNF-α R2), had similar performance when added to the CDP model (AUC = 0.829 [95% CI: 0.808-0.849]).
  
  
  CONCLUSIONS
  The combined use of serum adiponectin and TNF-α R2 as biomarkers provided added value over traditional risk factors for diabetes prediction in Chinese and could be considered as an alternative to the OGTT.
authors.affiliation: Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Yu-Cho
authors.initials: YC
authors.lastname: Woo
authors.forename: Annette W K
authors.initials: AW
authors.lastname: Tso
authors.forename: Aimin
authors.initials: A
authors.lastname: Xu
authors.forename: Lawrence S C
authors.initials: LS
authors.lastname: Law
authors.forename: Carol H Y
authors.initials: CH
authors.lastname: Fong
authors.forename: Tai-Hing
authors.initials: TH
authors.lastname: Lam
authors.forename: Su-Vui
authors.initials: SV
authors.lastname: Lo
authors.forename: Nelson M S
authors.initials: NM
authors.lastname: Wat
authors.forename: Bernard M Y
authors.initials: BM
authors.lastname: Cheung
authors.forename: Karen S L
authors.initials: KS
authors.lastname: Lam
mesh_terms: D052242:Adiponectin / Q000097:blood*; D001786:Blood Glucose / Q000032:analysis*; D006723:Hong Kong; D006801:Humans; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000097:blood*
chemical_list: D052242:Adiponectin; D001786:Blood Glucose; D047889:Receptors, Tumor Necrosis Factor, Type II