Public Health, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
Diabetes Metab Res Rev. 2012 May;28(4):349-56. doi: 10.1002/dmrr.2277.
It was suggested that inflammation may mediate or modify biological effects of adiponectin. Few studies examined the association between circulating adiponectin levels and type 2 diabetes (T2DM) while controlling for variables related to inflammation. In addition, East Asians were reported to have lower adiponectin levels but higher diabetes prevalence at a given degree of obesity than Caucasians, raising some possibility that the adiponectin-diabetes association may differ by race. Therefore, we prospectively investigated the associations with a number of covariates including C-reactive protein and smoking status in a cohort of Japanese workers aged 35-66 years.
Serum adiponectin concentration and other covariates were obtained in 2002 for 3008 civil servants free of T2DM at baseline in urban/suburban Japan. T2DM incidence was defined as the year when annually assessed fasting blood glucose level first exceeded 126 mg/dL or self-reported initiation of medication through 2007. T2DM incidence was examined in relation to the adiponectin quintile.
Age- and sex-adjusted homeostasis model assessment insulin resistance was inversely associated with adiponectin quintiles at baseline. During six years of follow-up, 164 individuals developed T2DM. In a fully adjusted model, hazard ratios (95% confidence intervals) of T2DM in Q2 to Q5 compared with that in Q1 were 0.62 (0.41-0.94), 0.44 (0.25-0.77), 0.40 (0.20-0.78) and 0.85 (0.48-1.49), respectively.
Low adiponectin was related to increased incidence of T2DM independent of baseline levels of blood glucose, insulin and C-reactive protein as well as other confounding variables in middle-aged Japanese. Whether high adiponectin is linearly associated with decreased T2DM risk needs further investigation.
有研究表明，炎症可能介导或调节脂联素的生物学效应。很少有研究在控制与炎症相关的变量的情况下，考察循环脂联素水平与 2 型糖尿病（T2DM）之间的关联。此外，与白种人相比，东亚人在肥胖程度相同的情况下，脂联素水平较低，但糖尿病患病率较高，这表明脂联素与糖尿病之间的关联可能因种族而异。因此，我们前瞻性地调查了日本城市/郊区的 3008 名公务员队列中与多个协变量（包括 C 反应蛋白和吸烟状况）的关联，这些人在基线时无 T2DM。
在日本城市/郊区，2002 年对 3008 名公务员进行了血清脂联素浓度和其他协变量的检测，这些公务员在基线时无 T2DM。T2DM 的发病率定义为每年评估空腹血糖水平首次超过 126mg/dL 或通过 2007 年自我报告开始药物治疗的那一年。检查了 T2DM 发病率与脂联素五分位数之间的关系。
在年龄和性别调整的稳态模型评估胰岛素抵抗指数中，基线时脂联素五分位数呈负相关。在六年的随访期间，有 164 人发生了 T2DM。在完全调整的模型中，与 Q1 相比，Q2 至 Q5 的 T2DM 的风险比（95%置信区间）分别为 0.62（0.41-0.94）、0.44（0.25-0.77）、0.40（0.20-0.78）和 0.85（0.48-1.49）。
在中年日本人中，低水平的脂联素与 T2DM 的发病率增加独立于基线血糖、胰岛素和 C 反应蛋白以及其他混杂变量有关。高水平的脂联素是否与 T2DM 风险降低呈线性相关，还需要进一步研究。
