Takahashi Naohiko, Anan Futoshi, Nakagawa Mikiko, Yufu Kunio, Shinohara Tetsuji, Tsubone Tetsuo, Goto Koro, Masaki Takayuki, Katsuragi Isao, Tanaka Katsuhiro, Kakuma Testsuya, Hara Masahide, Saikawa Tetsunori, Yoshimatsu Hironobu
Department of Internal Medicine 1, Faculty of Medicine, Oita University, Oita 879-5593, Japan.
Metabolism. 2007 Jul;56(7):919-24. doi: 10.1016/j.metabol.2007.02.005.
Hypoadiponectinemia is associated with insulin resistance. However, there is very limited information about the relationship between plasma adiponectin and cardiac autonomic nervous function. We tested the hypothesis that hypoadiponectinemia is associated with cardiac sympathetic overactivity in patients with type 2 diabetes mellitus. Thirty-three male type 2 diabetic patients not on insulin treatment were classified into a hypoadiponectinemia group (plasma adiponectin concentration, <4.0 microg/mL; age, 58.6 +/- 8.6 years [mean +/- SD]; n = 14) and an age-matched normoadiponectinemia group (serum adiponectin concentration, >/=4.0 microg/mL; age, 58.2 +/- 8.1 years; n = 19). In each patient, baroreflex sensitivity, heart rate variability, plasma norepinephrine concentration, and cardiac (123)I-metaiodobenzylguanidine (MIBG) scintigraphic findings were assessed. Compared with the normoadiponectinemia group, the hypoadiponectinemia group had a higher body mass index (P < .01), higher plasma concentrations of glucose and insulin (P < .05 and P < .01, respectively), higher homeostasis model assessment of insulin resistance (HOMA-IR) values (P < .005), higher plasma triglyceride levels (P < .05), and lower plasma high-density lipoprotein cholesterol levels (P < .05). In the hypoadiponectinemia group, the autonomic function measurements included a lower baroreflex sensitivity (P< .05) and a lower delayed myocardial uptake of (123)I-MIBG (P < .01) with a higher washout rate (P < .05). Multiple regression analysis revealed that the plasma adiponectin level was independently associated with HOMA-IR (F = 9.916) and the percent washout rate of (123)I-MIBG (F = 5.985). Our results suggest that in middle-aged men with type 2 diabetes mellitus, hypoadiponectinemia is associated with cardiac sympathetic overactivity as determined by (123)I-MIBG scintigraphy.
低脂联素血症与胰岛素抵抗相关。然而，关于血浆脂联素与心脏自主神经功能之间关系的信息非常有限。我们检验了这样一个假设，即低脂联素血症与2型糖尿病患者的心脏交感神经过度活跃有关。33名未接受胰岛素治疗的男性2型糖尿病患者被分为低脂联素血症组（血浆脂联素浓度，<4.0微克/毫升；年龄，58.6±8.6岁[平均值±标准差]；n = 14）和年龄匹配的正常脂联素血症组（血清脂联素浓度，≥4.0微克/毫升；年龄，58.2±8.1岁；n = 19）。对每位患者评估压力反射敏感性、心率变异性、血浆去甲肾上腺素浓度以及心脏（123）I-间碘苄胍（MIBG）闪烁显像结果。与正常脂联素血症组相比，低脂联素血症组的体重指数更高（P <.01），血浆葡萄糖和胰岛素浓度更高（分别为P <.05和P <.01），胰岛素抵抗稳态模型评估（HOMA-IR）值更高（P <.005），血浆甘油三酯水平更高（P <.05），血浆高密度脂蛋白胆固醇水平更低（P <.05）。在低脂联素血症组中，自主神经功能测量结果包括较低的压力反射敏感性（P<.05）和较低的（123）I-MIBG心肌延迟摄取（P <.01）以及较高的洗脱率（P <.05）。多元回归分析显示，血浆脂联素水平与HOMA-IR（F = 9.916）和（123）I-MIBG的洗脱率百分比（F = 5.985）独立相关。我们的结果表明，在中年男性2型糖尿病患者中，低脂联素血症与通过（123）I-MIBG闪烁显像确定的心脏交感神经过度活跃有关。
