Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center, Zaloska 7, Ljubljana 1000, Slovenia.
J Endocrinol Invest. 2010 Sep;33(8):514-8. doi: 10.1007/BF03346639. Epub 2010 Feb 5.
Adiponectin and leptin are adipocytokines associated with insulin resistance. The objective of this study was to evaluate the performance of the adiponectin-leptin ratio as a measure of insulin resistance in comparison with other surrogate measures of insulin resistance based on fasting insulin and glucose levels [homeostasis model assessment (HOMA), quantitative insulin sensitivity check index (QUICKI), fasting glucose/insulin ratio] and with measures based on fasting insulin and triglyceride levels (McAuley index) in Caucasian patients with Type 2 diabetes (T2D).
In 70 patients included in DEMAND (delapril and manidipine for nephroprotection in diabetes) study, fasting samples of plasma insulin and adiponectin were determined by a radioimmunoassay, whereas plasma leptin was determined by an enzyme-linked immunosorbent assay. Insulin resistance estimates were derived by the established equations and compared with the direct measurement of insulin resistance obtained with the euglycemic hyperinsulinemic clamp. Insulin resistance estimates and the clamp derived sensitivity index were compared by correlation analysis.
The adiponectin-leptin ratio correlated best with the clamp derived sensitivity index (r=0.553, p<0.001) compared to other surrogate measures of insulin resistance. In multiple linear regression models including different surrogate measures of insulin resistance as independent predictors of the sensitivity index, the model with the adiponectin-leptin ratio accounted for the highest variability of the sensitivity index (r2=0.336, p<0.001).
The adiponectin-leptin ratio is associated with insulin resistance, measured with the euglycemic hyperinsulinemic clamp, in Caucasians with T2D. The association with clamp derived sensitivity index is even stronger than that of HOMA, QUICKI, fasting glucose/insulin ratio or McAuley index and is independent of body mass index or glycemic control. The adiponectin-leptin ratio promises to become a new laboratory marker of insulin resistance in T2D.
脂联素和瘦素是与胰岛素抵抗相关的脂肪细胞因子。本研究的目的是评估脂联素-瘦素比值作为胰岛素抵抗的衡量指标的性能，与基于空腹胰岛素和血糖水平的其他胰岛素抵抗替代指标（稳态模型评估[HOMA]、定量胰岛素敏感性检查指数[QUICKI]、空腹血糖/胰岛素比值）以及基于空腹胰岛素和甘油三酯水平的指标（McAuley 指数）进行比较，这些指标都是在 2 型糖尿病（T2D）的白种人群中进行评估的。
在参与 DEMAND（赖诺普利和马尼地平在糖尿病中的肾脏保护作用）研究的 70 例患者中，通过放射免疫分析法测定血浆胰岛素和脂联素的空腹样本，通过酶联免疫吸附法测定血浆瘦素。通过已建立的方程得出胰岛素抵抗估计值，并与通过正葡萄糖高胰岛素钳夹获得的直接胰岛素抵抗测量值进行比较。通过相关分析比较胰岛素抵抗估计值和钳夹衍生的敏感性指数。
与其他胰岛素抵抗替代指标相比，脂联素-瘦素比值与钳夹衍生的敏感性指数相关性最好（r=0.553，p<0.001）。在包含不同胰岛素抵抗替代指标作为敏感性指数独立预测因子的多元线性回归模型中，包含脂联素-瘦素比值的模型可以解释敏感性指数的最大变异性（r2=0.336，p<0.001）。
在白种人 2 型糖尿病患者中，脂联素-瘦素比值与通过正葡萄糖高胰岛素钳夹测量的胰岛素抵抗相关。与钳夹衍生的敏感性指数的相关性甚至强于 HOMA、QUICKI、空腹血糖/胰岛素比值或 McAuley 指数，且与体重指数或血糖控制无关。脂联素-瘦素比值有望成为 2 型糖尿病胰岛素抵抗的新实验室标志物。
