title: Association of serum adiponectin with diabetic microvascular complications among south Indian type 2 diabetic subjects - (CURES-133).
abstract: OBJECTIVE
  To assess the association of serum adiponectin and microvascular complications of diabetes in an urban south Indian type 2 diabetic population.
  
  
  METHODS
  Diabetic subjects [n=487] were included from Chennai Urban Rural Epidemiology Study (CURES). Four-field stereo retinal color photography was done and diabetic retinopathy (DR) was classified as non-proliferative DR (NPDR) or proliferative DR (PDR) according to the Early Treatment Diabetic Retinopathy Study grading system. Sight threatening DR (STDR) was defined as the presence of NPDR with diabetic macular edema, and/or PDR. Neuropathy was diagnosed if vibratory perception threshold of the great toe using biothesiometry exceeded ≥20V. Nephropathy was diagnosed if urinary albumin excretion (UAE) was ≥30μg/mg creatinine. Serum total adiponectin levels were measured by radioimmunoassay.
  
  
  RESULTS
  Subjects with any microvascular complications had significantly higher levels of adiponectin levels compared to those without the complications (geometric mean: 6.1 vs. 5.3μg/mL, p=0.004). The adiponectin level was significantly higher in subjects with DR (6.8 vs. 5.5μg/mL, p=0.004) and neuropathy (5.6 vs. 6.5μg/mL, p=0.024) compared to those without. Adiponectin levels were not significantly different in subjects with and without nephropathy. Serum adiponectin levels increased with the severity of DR [No DR - 5.5μg/mL; NPDR without DME - 6.5μg/mL; STDR - 8.3μg/mL, p=0.001]. Regression analysis revealed adiponectin to be associated with microvascular disease (presence of neuropathy and/or retinopathy and/or nephropathy) (OR: 1.44, 95% CI: 1.01-2.06, p=0.049) even after adjusting for age, gender, BMI, HbA1c, diabetes of duration, serum cholesterol and triglycerides, hypertension and medication status.
  
  
  CONCLUSIONS
  In Asian Indians with type 2 diabetes, serum adiponectin levels are associated with microvascular complications and also with the severity of retinopathy.
authors.affiliation: Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention & Control, IDF Centre of Education, Gopalapuram, Chennai, India.
authors.forename: R
authors.initials: R
authors.lastname: Pradeepa
authors.affiliation: Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention & Control, IDF Centre of Education, Gopalapuram, Chennai, India.
authors.forename: J
authors.initials: J
authors.lastname: Surendar
authors.affiliation: Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention & Control, IDF Centre of Education, Gopalapuram, Chennai, India.
authors.forename: K
authors.initials: K
authors.lastname: Indulekha
authors.affiliation: Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention & Control, IDF Centre of Education, Gopalapuram, Chennai, India.
authors.forename: S
authors.initials: S
authors.lastname: Chella
authors.affiliation: Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention & Control, IDF Centre of Education, Gopalapuram, Chennai, India.
authors.forename: R M
authors.initials: RM
authors.lastname: Anjana
authors.affiliation: Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention & Control, IDF Centre of Education, Gopalapuram, Chennai, India. Electronic address: drmohans@diabetes.ind.in.
authors.forename: V
authors.initials: V
authors.lastname: Mohan
mesh_terms: D052242:Adiponectin / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications*; D003925:Diabetic Angiopathies / Q000097:blood* / Q000150:complications*; D003930:Diabetic Retinopathy / Q000097:blood / Q000150:complications; D005260:Female; D006801:Humans; D007194:India; D016015:Logistic Models; D008297:Male; D008875:Middle Aged
chemical_list: D052242:Adiponectin
keywords: CURES; Diabetic retinopathy; Nephropathy; Neuropathy; Serum adiponectin; South Indians; Type 2 diabetes