Mantzoros Christos S, Li Tricia, Manson JoAnn E, Meigs James B, Hu Frank B
Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, ST 816, Boston, Massachusetts 02215, USA.
J Clin Endocrinol Metab. 2005 Aug;90(8):4542-8. doi: 10.1210/jc.2005-0372. Epub 2005 May 24.
Low adiponectin levels, by regulating insulin resistance and metabolic profile, may contribute to the markedly increased risk of atherosclerosis in diabetic subjects.
The complex interrelationships between adiponectin and metabolic abnormalities have not yet been fully assessed in diabetic women.
DESIGN/SETTING/PATIENTS: We performed a cross-sectional evaluation of the association between circulating adiponectin and glycemia, lipid-lipoprotein levels, and inflammatory markers in 925 women with type 2 diabetes enrolled in the Nurses' Health Study.
Circulating adiponectin levels were significantly and positively associated with high-density lipoprotein (HDL) cholesterol and physical activity levels, and inversely with body mass index and plasma concentrations of hemoglobin A1c (HgbA1c), triglycerides, non-HDL cholesterol, apolipoprotein B-100, C-reactive protein, fibrinogen, soluble E-selectin, and soluble intercellular adhesion molecule-1. The above associations were not appreciably altered after adjusting for lifestyle factors, existing medical conditions, obesity, and body fat distribution, with the exception of HgbA1c and soluble intercellular adhesion molecule-1 (which became nonsignificant). Associations between adiponectin and inflammatory markers persisted after control for the potential confounding effects of HgbA1C and HDL cholesterol, suggesting that the antiinflammatory properties of adiponectin are not mediated by its effect on glycemia and lipidemia. With the exception of the associations with triglycerides and apolipoprotein B100, which were significant only in subjects with body mass index less than 30, all other associations observed herein were consistent among obese and nonobese diabetic women.
In summary, higher adiponectin levels are associated with better glycemic control, more favorable lipid profile, and reduced inflammation in diabetic women.
脂联素水平较低,通过调节胰岛素抵抗和代谢状况,可能会导致糖尿病患者动脉粥样硬化风险显著增加。
在糖尿病女性中,脂联素与代谢异常之间的复杂相互关系尚未得到充分评估。
设计/地点/患者:我们对参加护士健康研究的925名2型糖尿病女性患者进行了横断面评估,以研究循环脂联素与血糖、脂质 - 脂蛋白水平及炎症标志物之间的关联。
循环脂联素水平与高密度脂蛋白(HDL)胆固醇和身体活动水平显著正相关,与体重指数、糖化血红蛋白(HgbA1c)、甘油三酯、非HDL胆固醇、载脂蛋白B - 100、C反应蛋白、纤维蛋白原、可溶性E选择素和可溶性细胞间黏附分子 - 1的血浆浓度呈负相关。在调整生活方式因素、现有疾病、肥胖和体脂分布后,上述关联除HgbA1c和可溶性细胞间黏附分子 - 1(变得无统计学意义)外,均无明显改变。在控制了HgbA1C和HDL胆固醇的潜在混杂效应后,脂联素与炎症标志物之间的关联仍然存在,这表明脂联素的抗炎特性并非由其对血糖和血脂的影响介导。除了与甘油三酯和载脂蛋白B100的关联仅在体重指数小于30的受试者中显著外,本文观察到的所有其他关联在肥胖和非肥胖糖尿病女性中均一致。
总之,较高的脂联素水平与糖尿病女性更好的血糖控制、更有利的血脂谱和炎症减轻相关。