title: Treatment-Induced Changes in Plasma Adiponectin Do Not Reduce Urinary Albumin Excretion in the Diabetes Prevention Program Cohort.
abstract: OBJECTIVE
  Molecular data suggests that adiponectin may directly regulate urinary albumin excretion. In the Diabetes Prevention Program (DPP) we measured adiponectin and albuminuria before and after intervention, and we previously reported increases in adiponectin with interventions. Here we have used the DPP dataset to test the hypothesis that treatment-related increases in adiponectin may reduce albuminuria in obesity.
  
  
  METHODS
  We evaluated cross-sectional correlations between plasma adiponectin and urinary albumin excretion at baseline, and the relationship of treatment-related changes in adiponectin and albuminuria. Baseline and follow-up urine albumin to creatinine ratios (ACR (albumin to creatinine ratio)) and plasma adiponectin concentration were available in 2553 subjects.
  
  
  RESULTS
  Adjusting for age, sex and race/ethnicity, we observed a statistically significant but weak inverse relationship between adiponectin and ACR at baseline (conditional Spearman's rho = (-) 0.04, p = 0.04). Although DPP treatments significantly increased plasma adiponectin, there were no treatment effects on ACR and no differences in ACR across treatment groups. There was a weak direct (not inverse) association between change in adiponectin and change in albuminuria (adjusted Spearman's rho = (+) 0.04, p = 0.03).
  
  
  CONCLUSIONS
  In a large, well-characterized cohort of obese dysglycemic subjects we observed a weak inverse association between circulating adiponectin concentrations and urinary albumin excretion at baseline. Contrary to the hypothesized effect, treatment-related increases in plasma adiponectin were not associated with a reduction in ACR. The association of change in adiponectin with change in ACR should be assessed in populations with overt albuminuria before excluding a beneficial effect of increasing adiponectin to reduce ACR in obesity.
authors: Division of Endocrinology and Metabolism, Indiana University, Indianapolis, Indiana, United States of America.
authors: Kieren J
authors: KJ
authors: Mather
authors: The Biostatistics Center, The George Washington University, Rockville, Maryland, United States of America.
authors: Qing
authors: Q
authors: Pan
authors: Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona, United States of America.
authors: William C
authors: WC
authors: Knowler
authors: Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
authors: Tohru
authors: T
authors: Funahashi
authors: Pennington Biomedical Center, Baton Rouge, Louisiana, United States of America.
authors: George A
authors: GA
authors: Bray
authors: Dept. of Medicine, Diabetes and Endocrinology, University of Hawaii, Honolulu, Hawaii, United States of America.
authors: Richard
authors: R
authors: Arakaki
authors: Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America.
authors: Bonita
authors: B
authors: Falkner
authors: Division of Nephrology and Hypertension and Center for Renal Translational Medicine, Department of Medicine, University of California San Diego/Veterans Affairs San Diego Healthcare System, San Diego, California, United States of America.
authors: Kumar
authors: K
authors: Sharma
authors: Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America.
authors: Barry J
authors: BJ
authors: Goldstein
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000419:Albuminuria / Q000652:urine*; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000628:therapy; D040242:Risk Reduction Behavior
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D008687:Metformin; D003404:Creatinine