Choi K M, Lee J, Lee K W, Seo J A, Oh J H, Kim S G, Kim N H, Choi D S, Baik S H
Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.
Clin Endocrinol (Oxf). 2004 Jul;61(1):75-80. doi: 10.1111/j.1365-2265.2004.02063.x.
To determine whether low serum adiponectin concentrations are able to predict the future developments of type 2 diabetes and the metabolic syndrome using the National Cholesterol Education Programme (NCEP) criteria. We also investigated the stability of adiponectin levels and the relationships between baseline adiponectin levels and changes in the parameters related to the metabolic syndrome over a period of 3 years.
This prospective cohort study included 372 elderly Koreans who participate in the SWS (South-West Seoul) study, which was conducted in 1999 and 2002 in Seoul, Korea. Fasting and postchallenge 2-h plasma glucose, body mass index (BMI), waist-to-hip ratio (WHR), blood pressure, lipid profiles and serum adiponectin data obtained in 1999 and 2002 were examined.
The within-person variation between 1999 and 2002 of serum adiponectin was not significant (P = 0.61). Serum adiponectin was closely correlated with the risks factors of cardiovascular disease (CVD), that is negatively with BMI, WHR, blood pressure, triglyceride and blood glucose levels, and positively with high density lipoprotein (HDL)-cholesterol levels. Subjects with the metabolic syndrome showed lower serum adiponectin concentrations than those without the metabolic syndrome (P < 0.0001). Baseline adiponectin levels were found to be correlated with subsequent changes in WHR, low density lipoprotein (LDL)-cholesterol, fasting and postload 2-h glucose over the 3-year period, after adjusting for baseline values. Multiple logistic regression analysis showed that lower baseline serum adiponectin concentrations were significantly associated with the developments of type 2 diabetes and the metabolic syndrome after adjusting for age, sex, obesity, history of impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), hypertension and dyslipidaemia.
Reduced concentrations of adiponectin were found to be independently associated with increased risk of both type 2 diabetes and the metabolic syndrome in elderly Koreans.
利用美国国家胆固醇教育计划（NCEP）标准，确定低血清脂联素浓度是否能够预测2型糖尿病和代谢综合征的未来发展。我们还研究了脂联素水平的稳定性，以及在3年期间基线脂联素水平与代谢综合征相关参数变化之间的关系。
这项前瞻性队列研究纳入了372名参与SWS（首尔西南部）研究的韩国老年人，该研究于1999年和2002年在韩国首尔进行。对1999年和2002年获取的空腹及餐后2小时血浆葡萄糖、体重指数（BMI）、腰臀比（WHR）、血压、血脂谱和血清脂联素数据进行了检查。
1999年至2002年血清脂联素的个体内变异不显著（P = 0.61）。血清脂联素与心血管疾病（CVD）危险因素密切相关，即与BMI、WHR、血压、甘油三酯和血糖水平呈负相关，与高密度脂蛋白（HDL）胆固醇水平呈正相关。患有代谢综合征的受试者血清脂联素浓度低于未患代谢综合征的受试者（P < 0.0001）。在调整基线值后，发现基线脂联素水平与3年期间WHR、低密度脂蛋白（LDL）胆固醇、空腹及负荷后2小时血糖的后续变化相关。多因素logistic回归分析显示，在调整年龄、性别、肥胖、空腹血糖受损（IFG）或糖耐量受损（IGT）病史、高血压和血脂异常后，较低的基线血清脂联素浓度与2型糖尿病和代谢综合征的发生显著相关。
在韩国老年人中，脂联素浓度降低与2型糖尿病和代谢综合征风险增加独立相关。
