Lai Huasheng, Lin Nie, Xing Zhenzhen, Weng Huanhuan, Zhang Hua
Department of Endocrinology, Zhujiang Hospital of Southern Medical University Guangzhou, China.
J Diabetes Investig. 2015 Jul;6(4):416-29. doi: 10.1111/jdi.12321. Epub 2015 Mar 31.
AIMS/INTRODUCTION: Adiponectin has been proposed to have an essential role in the regulation of insulin sensitivity and metabolism, but previous studies on levels of adiponectin in prediabetes remain inconsistent. The present study aimed to assess the differences of adiponectin levels between prediabetes patients and healthy controls by carrying out a meta-analysis.
We carried out a systematic literature search of PubMed, EMBASE, and other databases for case-control studies and cohort studies measuring adiponectin levels in serum or plasma from prediabetes patients and healthy controls. The pooled weighted mean difference (WMD) and 95% confidence interval (CI) were used to estimate the association between adiponectin levels and prediabetes.
Three cohort studies and 15 case-control studies with a total of 41,841 participants were included in the meta-analysis. The results showed that circulating adiponectin levels in prediabetes patients were significantly lower than that of healthy controls (WMD -1.694 μg/mL; 95% CI -2.151, -1.237; P < 0.001). Subgroup analysis showed more significant differences between prediabetes patients and healthy controls when the ratio of the homeostatic model assessment of insulin resistance was >2.12 (WMD -2.95 μg/mL; 95% CI -4.103, -1.806; P < 0.001) and average age was >60 years (WMD -2.20 μg/mL; 95% CI -3.207, -1.201; P < 0.001). Additionally, WMD in adiponectin showed a trend of direct correlation in subgroups of homeostatic model assessment of insulin resistance ratio, body mass index and age.
The present meta-analysis supports adiponectin levels in prediabetes patients being lower than that of healthy controls,indicating that the level of circulating adiponectin decreases before the onset of diabetes.
目的/引言:脂联素被认为在胰岛素敏感性和代谢调节中起重要作用,但先前关于糖尿病前期脂联素水平的研究结果并不一致。本研究旨在通过荟萃分析评估糖尿病前期患者与健康对照者之间脂联素水平的差异。
我们对PubMed、EMBASE和其他数据库进行了系统的文献检索,以查找测量糖尿病前期患者和健康对照者血清或血浆中脂联素水平的病例对照研究和队列研究。采用合并加权平均差(WMD)和95%置信区间(CI)来估计脂联素水平与糖尿病前期之间的关联。
荟萃分析纳入了3项队列研究和15项病例对照研究,共41841名参与者。结果显示,糖尿病前期患者的循环脂联素水平显著低于健康对照者(WMD -1.694μg/mL;95%CI -2.151,-1.237;P <0.001)。亚组分析显示,当胰岛素抵抗稳态模型评估比值>2.12(WMD -2.95μg/mL;95%CI -4.103,-1.806;P <0.001)且平均年龄>60岁(WMD -2.20μg/mL;95%CI -3.207,-1.201;P <0.001)时,糖尿病前期患者与健康对照者之间的差异更为显著。此外,脂联素的WMD在胰岛素抵抗比值、体重指数和年龄的稳态模型评估亚组中呈直接相关趋势。
本荟萃分析支持糖尿病前期患者的脂联素水平低于健康对照者,表明循环脂联素水平在糖尿病发病前降低。