title: Relationship of adiponectin to markers of oxidative stress in type 2 diabetic patients: influence of incipient diabetes-associated kidney disease.
abstract: OBJECTIVE
  Adiponectin may be beneficial in incipient chronic kidney disease by antagonizing oxidative stress. We evaluated adiponectin, malondialdehyde (MDA), and superoxide dismutase (SOD), in type 2 diabetes mellitus patients (T2DP) with and without incipient nephropathy.
  
  
  METHODS
  T2DP with glomerular filtration rate (GFR) >30 ml/min were compared with 20 healthy controls. Clinical and laboratory evaluations, levels of MDA (fluorimetric thiobarbituric test), SOD (cytochrome reduction method) and adiponectin (ELISA) were obtained.
  
  
  RESULTS
  Sixty-four patients (GFR 91.44 ± 38.50 ml/min, urinary albumin-to-creatinine ratio [UACR] 20.81 [4.64-72.88 mg/g]) were included. MDA was higher in T2DP than in controls: 3.97 (2.43-4.59) versus 1.35 (1.16-1.81) nmol/ml, p < 0.0001. MDA correlated with glycated hemoglobin (r = 0.40, p = 0.001), adiponectin (r = -0.28, p = 0.03), systolic blood pressure (r = -0.28, p = 0.03) and SOD (r = -0.35, p = 0.005); adiponectin (p = 0.01) and glycated hemoglobin (p = 0.02) remained significant predictors of MDA in multiple regression analysis. SOD was negatively correlated with glycemia (r = -0.71, p < 0.0001) and glycated hemoglobin (r = -0.5, p < 0.0001). When patients were divided according to a ROC-derived adiponectin cutoff of 8.9 µg/ml, patients with higher adiponectin had lower MDA, [2.55 (2.35-3.60) vs. 4.10 (2.89-5.31) nmol/ml, p = 0.005] but similar SOD levels. In T2DP with nephropathy (GFR < 60 ml/min or UACR > 30 mg/g), the correlation of adiponectin with MDA was stronger, (r = -0.51, p = 0.004) confirmed in multiple regression analysis (p = 0.03). Adiponectin was not correlated with MDA, and SOD was inversely related to MDA in patients without nephropathy.
  
  
  CONCLUSIONS
  Adiponectin is a significant predictor of MDA in early diabetic nephropathy, whereas SOD strongly depends only on glycemic control and is not directly related to adiponectin.
authors.affiliation: Department of Informatics and Biostatistics, University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj, 6 Pasteur Street, 400349, Cluj-Napoca, Romania.
authors.forename: Cosmina Ioana
authors.initials: CI
authors.lastname: Bondor
authors.forename: Alina Ramona
authors.initials: AR
authors.lastname: Potra
authors.forename: Diana
authors.initials: D
authors.lastname: Moldovan
authors.forename: Crina Claudia
authors.initials: CC
authors.lastname: Rusu
authors.forename: Mariana
authors.initials: M
authors.lastname: Ciorba Pop
authors.forename: Adriana
authors.initials: A
authors.lastname: Muresan
authors.forename: Dan Stefan
authors.initials: DS
authors.lastname: Vladutiu
authors.forename: Ina Maria
authors.initials: IM
authors.lastname: Kacso
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000368:Aged; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology; D042241:Early Diagnosis; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007677:Kidney Function Tests / Q000379:methods; D008297:Male; D008315:Malondialdehyde / Q000097:blood*; D008875:Middle Aged; D018384:Oxidative Stress; D011237:Predictive Value of Tests; D011379:Prognosis; D012383:Romania; D013482:Superoxide Dismutase / Q000097:blood*
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D008315:Malondialdehyde; D013482:Superoxide Dismutase