The Research and Development Unit, Jämtland County Council, Östersund, Sweden.
Metab Syndr Relat Disord. 2012 Apr;10(2):143-51. doi: 10.1089/met.2011.0123. Epub 2012 Jan 27.
Adiponectin and leptin and their ratio have been associated with incident type 2 diabetes (T2DM), although the data presented are conflicting and the populations studied have been small. In this large, prospective, nested, case referent study, we hypothesized that these associations are sex specific and may be modified by insulin resistance.
Men and women aged 30-60 years with incident T2DM (n=640) and a prior health survey within the Västerbotten Intervention Programme (VIP) and matched referents (n=1564) were identified. Using conditional logistic regression analyses, we tested whether baseline plasma adiponectin and leptin levels and their ratio independently predicted incident T2DM, stratified for gender and insulin resistance.
Adjusted for traditional risk factors, fourth-quartile levels of adiponectin were associated with a reduced risk of T2DM in men [odds ratio (OR) 0.55 (0.36-0.86)] and women [OR 0.47 (0.27-0.83)]. Quartile four of the leptin/adiponectin ratio predicted T2DM in both men [OR 3.08 (1.68-5.67)] and women [OR 3.31 (1.56-7.03)], whereas quartile-four levels of leptin predicted T2DM only in men [OR 2.30 (1.32-4.02)]. When stratified for insulin sensitivity and adjusted for body mass index (BMI), log(e)-transformed leptin predicted T2DM in insulin-sensitive men [OR 1.56 (1.13-2.17)] but not in insulin-resistant men [OR 1.03 (0.76-1.39)]. The effect of adiponectin and the leptin/adiponectin ratio was not influenced by the insulin sensitivity status.
Leptin in men and adiponectin in both sexes were independent predictors of T2DM. The association was modified by the degree of insulin sensitivity. The leptin/adiponectin ratio may add predictive information beyond the separate hormones.
脂联素和瘦素及其比值与 2 型糖尿病（T2DM）的发生有关，尽管目前的数据存在矛盾，且研究人群较小。在这项大型、前瞻性、嵌套、病例对照研究中，我们假设这些关联具有性别特异性，并且可能受到胰岛素抵抗的影响。
在维斯特博滕干预计划（VIP）中，我们确定了年龄在 30-60 岁之间的男性和女性，这些人患有新的 T2DM（n=640），并且在之前的健康调查中有数据，同时还确定了匹配的对照者（n=1564）。使用条件逻辑回归分析，我们测试了基础血浆脂联素和瘦素水平及其比值是否独立预测 T2DM，按性别和胰岛素抵抗进行分层。
调整传统危险因素后，男性第四四分位脂联素水平与 T2DM 风险降低相关[比值比（OR）0.55（0.36-0.86）]，女性也呈此趋势[OR 0.47（0.27-0.83）]。瘦素/脂联素比值的四分位数四预测男性和女性的 T2DM[男性 OR 3.08（1.68-5.67），女性 OR 3.31（1.56-7.03）]，而四分位四的瘦素水平仅预测男性的 T2DM[OR 2.30（1.32-4.02）]。按胰岛素敏感性分层，并根据体重指数（BMI）进行调整后，log(e)转换后的瘦素预测胰岛素敏感男性的 T2DM[OR 1.56（1.13-2.17）]，但对胰岛素抵抗男性无影响[OR 1.03（0.76-1.39）]。脂联素和瘦素/脂联素比值的作用不受胰岛素敏感性状态的影响。
男性的瘦素和两性的脂联素都是 T2DM 的独立预测因子。这种关联受到胰岛素敏感性程度的影响。瘦素/脂联素比值可能比单独的激素提供更多的预测信息。
