Schulze Matthias B, Rimm Eric B, Shai Iris, Rifai Nader, Hu Frank B
Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
Diabetes Care. 2004 Jul;27(7):1680-7. doi: 10.2337/diacare.27.7.1680.
Adiponectin, synthesized in the adipose tissue, appears to play an important role in hyperglycemia and dyslipidemia, as well as in inflammatory mechanisms, which lead to a markedly increased atherosclerotic risk in diabetic subjects. However, previous studies did not evaluate the complex relationships between adiponectin and the array of metabolic abnormalities commonly observed in diabetes.
To examine the associations between plasma levels of adiponectin and HbA(1c), blood lipids, and inflammatory markers, we obtained blood samples from 741 participants in the Health Professionals Follow-up Study with a diagnosis of type 2 diabetes.
Plasma adiponectin levels were positively correlated with HDL cholesterol and negatively correlated with triglycerides, apolipoprotein B-100 (apoB(100)), C-reactive protein (CRP), and fibrinogen. These associations were not appreciably altered after controlling for lifestyle exposures, medical conditions, and obesity-associated variables. A 10-microg/ml higher level of plasma adiponectin was associated with lower HbA(1c) (-0.21% points, P = 0.001), triglycerides (-0.39 mmol/l, P < 0.001), apoB(100) (-0.04 g/l, P < 0.001), CRP (-0.51 mg/l, P = 0.003), and fibrinogen (-0.53 micromol/l, P < 0.001) and higher HDL cholesterol (0.13 mmol/l, P < 0.001). Associations between adiponectin and inflammatory markers were furthermore independent of HbA(1c) and HDL cholesterol, suggesting that the anti-inflammatory properties of adiponectin are not mediated by potential effects on glycemic control and blood lipids. Our results were consistent among obese and nonobese men.
Our study supports the hypothesis that increased adiponectin levels might be associated with better glycemic control, better lipid profile, and reduced inflammation in diabetic subjects. Measures that increase adiponectin levels might be valuable targets for decreasing the atherosclerotic risk present in diabetes.
脂联素在脂肪组织中合成,似乎在高血糖和血脂异常以及炎症机制中发挥重要作用,而这些机制会导致糖尿病患者动脉粥样硬化风险显著增加。然而,先前的研究并未评估脂联素与糖尿病中常见的一系列代谢异常之间的复杂关系。
为了研究血浆脂联素水平与糖化血红蛋白(HbA1c)、血脂及炎症标志物之间的关联,我们从健康专业人员随访研究中741名诊断为2型糖尿病的参与者处采集了血样。
血浆脂联素水平与高密度脂蛋白胆固醇呈正相关,与甘油三酯、载脂蛋白B-100(apoB100)、C反应蛋白(CRP)和纤维蛋白原呈负相关。在控制了生活方式因素、健康状况及肥胖相关变量后,这些关联没有明显改变。血浆脂联素水平每升高10微克/毫升,与更低的糖化血红蛋白(-0.21%,P = 0.001)、甘油三酯(-0.39毫摩尔/升,P < 0.001)、apoB100(-0.04克/升,P < 0.001)、CRP(-0.51毫克/升,P = 0.003)和纤维蛋白原(-0.53微摩尔/升,P < 0.001)以及更高的高密度脂蛋白胆固醇(0.13毫摩尔/升,P < 0.001)相关。脂联素与炎症标志物之间的关联进一步独立于糖化血红蛋白和高密度脂蛋白胆固醇,这表明脂联素的抗炎特性并非由对血糖控制和血脂的潜在影响介导。我们的结果在肥胖和非肥胖男性中是一致的。
我们的研究支持这样的假说,即脂联素水平升高可能与糖尿病患者更好的血糖控制、更好的血脂谱及炎症减轻相关。提高脂联素水平的措施可能是降低糖尿病患者动脉粥样硬化风险的有价值靶点。