Maahs David M, Ogden Lorraine G, Snell-Bergeon Janet K, Kinney Gregory L, Wadwa R Paul, Hokanson John E, Dabelea Dana, Kretowski Adam, Eckel Robert H, Rewers Marian
Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center, Aurora, CO 80045, USA.
Am J Epidemiol. 2007 Sep 15;166(6):731-40. doi: 10.1093/aje/kwm125. Epub 2007 Jun 24.
Low levels of adiponectin have been related to coronary heart disease, but adiponectin is higher in persons with type 1 diabetes who have an increased rate of coronary disease. In the Coronary Artery Calcification in Type 1 Diabetes Study (2000-2002), the authors investigated potential determinants of elevated adiponectin levels in persons with type 1 diabetes and whether a difference exists compared with nondiabetic persons. Serum adiponectin was measured in 1,393 persons (sex: 48% male; age: 38 (standard deviation: 9) years; diabetes duration: 23 (standard deviation: 9) years; 54% nondiabetic and 46% with type 1 diabetes). Determinants of log-transformed adiponectin levels were evaluated by multiple linear regression analysis with interaction terms to determine whether predictors of adiponectin levels differed by diabetes status. Adiponectin levels were higher in type 1 diabetic than nondiabetic persons (13.5 (standard deviation: 1.0) vs. 8.8 (standard deviation: 1.0) microg/ml; p < 0.0001), adjusting for age, gender, body mass index, and glomerular filtration rate. The final regression model explained 67% of the difference in adiponectin levels between type 1 diabetic and nondiabetic persons. The variables explaining this difference included high density lipoprotein cholesterol, albumin excretion rate, plasminogen activator inhibitor-1, and hemoglobin A1c level. Adiponectin is higher in type 1 diabetic than nondiabetic persons. Although some of the difference can be explained, further study is needed to better understand the relation between elevated adiponectin levels and patient outcomes, including coronary heart disease.
脂联素水平较低与冠心病相关，但在冠心病发病率增加的1型糖尿病患者中，脂联素水平较高。在1型糖尿病冠状动脉钙化研究（2000 - 2002年）中，作者调查了1型糖尿病患者脂联素水平升高的潜在决定因素，以及与非糖尿病患者相比是否存在差异。对1393人（性别：48%为男性；年龄：38（标准差：9）岁；糖尿病病程：23（标准差：9）年；54%为非糖尿病患者，46%为1型糖尿病患者）测定了血清脂联素。通过多元线性回归分析及交互项评估对数转换后脂联素水平的决定因素，以确定脂联素水平的预测因素是否因糖尿病状态而异。在调整年龄、性别、体重指数和肾小球滤过率后，1型糖尿病患者的脂联素水平高于非糖尿病患者（13.5（标准差：1.0）对8.8（标准差：1.0）μg/ml；p < 0.0001）。最终回归模型解释了1型糖尿病患者与非糖尿病患者脂联素水平差异的67%。解释这种差异的变量包括高密度脂蛋白胆固醇、白蛋白排泄率、纤溶酶原激活物抑制剂-1和糖化血红蛋白水平。1型糖尿病患者的脂联素水平高于非糖尿病患者。虽然部分差异可以得到解释，但仍需要进一步研究以更好地理解脂联素水平升高与包括冠心病在内的患者预后之间的关系。
