Post-Graduate Endocrinology Program, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
Diabetol Metab Syndr. 2014 Feb 26;6(1):26. doi: 10.1186/1758-5996-6-26.
Adiponectin is a major regulator of glucose and lipid homeostasis by its insulin sensitizer properties. Since decreased insulin sensitivity is linked to metabolic syndrome (MS), decreased adiponectin levels may be related to its development. The purpose of the study was to investigate the relationship between adiponectin levels and MS.
Firstly, we cross-sectionally examined subjects with or without MS submitted to an oral glucose tolerance test at Hospital de Clínicas de Porto Alegre (n = 172). A replication analysis was performed in subjects (n = 422) undergoing cardiac angiography at Hospital São Paulo. Subchronic inflammation (US-CRP), coagulation marker (fibrinogen), insulin sensitivity and resistance (Matsuda ISI and HOMA-IR) were estimated. Plasma total and high molecular weight (HMW) adiponectin were measured.
Total and HMW adiponectin levels were lower in MS subjects (P < 0.05). Total adiponectin levels were lower in the presence of high waist circumference, low HDL-cholesterol and elevated triglyceride criteria in both samples and by elevated blood pressure and glucose criteria in Porto Alegre. HMW adiponectin levels were lower in the presence of low HDL-cholesterol, elevated triglycerides, and glucose criteria. Total adiponectin levels were positively related with HDL-cholesterol and ISI Matsuda, negatively related with waist circumference, glucose, triglycerides, HOMA-IR, and US-CRP and not related with blood pressure. While adjusting for sex and age, increased adiponectin levels remained associated with a reduced prevalence ratio for MS in both cohorts (P = 0.001).
Adiponectin levels decreased with increasing number of MS criteria, and it is in part determined by its relationship with HDL, triglycerides and abdominal adiposity.
脂联素通过其胰岛素增敏特性成为葡萄糖和脂质稳态的主要调节剂。由于胰岛素敏感性降低与代谢综合征(MS)有关,因此脂联素水平降低可能与其发病有关。本研究旨在探讨脂联素水平与 MS 的关系。
首先,我们在阿雷格里港临床医院(n=172)进行了口服葡萄糖耐量试验的 MS 患者和非 MS 患者的横断面研究。在圣保罗医院进行心脏血管造影的患者(n=422)中进行了复制分析。评估了亚慢性炎症(US-CRP)、凝血标志物(纤维蛋白原)、胰岛素敏感性和抵抗(Matsuda ISI 和 HOMA-IR)。测量了血浆总和高分子量(HMW)脂联素。
MS 患者的总脂联素和 HMW 脂联素水平较低(P<0.05)。在两个样本中,总脂联素水平在高腰围、低 HDL-胆固醇和升高的甘油三酯标准以及在阿雷格里港的升高血压和葡萄糖标准存在的情况下较低。在存在低 HDL-胆固醇、升高的甘油三酯和葡萄糖标准时,HMW 脂联素水平较低。总脂联素水平与 HDL-胆固醇和 Matsuda ISI 呈正相关,与腰围、血糖、甘油三酯、HOMA-IR 和 US-CRP 呈负相关,与血压无关。在校正性别和年龄后,在两个队列中,脂联素水平升高与 MS 的患病率比值降低相关(P=0.001)。
随着 MS 标准数量的增加,脂联素水平降低,部分原因是其与 HDL、甘油三酯和腹部肥胖的关系。