Long-term study of the association of adipokines and glucose variability with diabetic complications.
Recent studies have suggested an important role of adipokines in the development of insulin resistance and diabetes mellitus. The clinical relevance of adipokines on long-term outcomes in patients with diabetes and chronic kidney disease is uncertain. The purpose of this study was to identify a predictable factor in patients with long-term diabetic complications.



A total of 161 diabetic individuals were followed-up from 2002 to 2013. Circulating plasma levels of adiponectin, glypican-4, irisin, visfatin, and visit-to-visit glucose variability were measured in diabetic patients. Associations among adipokines and variable metabolic parameters and microvascular, and macrovascular complications were evaluated.



Plasma adiponectin and glypican-4 levels were significantly increased in patients with renal insufficiency. These adipokines were negatively associated with estimated glomerular filtration rate and positively associated with urinary albumin excretion. The relative risk of renal progression to dialysis increased independently with increasing level of adiponectin. Glypican-4 and visfatin were not predictive of any microvascular or macrovascular complications. Glucose variability increased the risk of diabetic nephropathy and cerebrovascular complications.



Adiponectin and glypican-4 were associated with renal function and might be able to predict renal progression. Glucose variability was a predictable factor for diabetic nephropathy and cerebrovascular complications.
Department of Nephrology, Korea University Ansan Hospital, Ansan, Korea.
Jin Joo
JJ
Cha
Department of Nephrology, Korea University Ansan Hospital, Ansan, Korea.
Hye Sook
HS
Min
Department of Nephrology, Korea University Ansan Hospital, Ansan, Korea.
Kitae
K
Kim
Department of Nephrology, Korea University Ansan Hospital, Ansan, Korea.
Mi Jin
MJ
Lee
Department of Nephrology, Korea University Ansan Hospital, Ansan, Korea.
Mi Hwa
MH
Lee
Department of Nephrology, Korea University Ansan Hospital, Ansan, Korea.
Jung Eun
JE
Kim
Department of Nephrology, Korea University Ansan Hospital, Ansan, Korea.
Hye Kyoung
HK
Song
Department of Nephrology, Korea University Ansan Hospital, Ansan, Korea.
Dae Ryong
DR
Cha
Department of Nephrology, Korea University Ansan Hospital, Ansan, Korea.
Young Sun
YS
Kang
D054392:Adipokines / Q000032:analysis; D052242:Adiponectin; D000293:Adolescent; D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003928:Diabetic Nephropathies; D005260:Female; D005947:Glucose; D053673:Glypicans / Q000032:analysis; D006801:Humans; D008297:Male; D011446:Prospective Studies
D054392:Adipokines; D052242:Adiponectin; D053673:Glypicans; D005947:Glucose
Adipokines; Adiponectin; Diabetes complications; Glucose variability; Glypicans