First Department of Internal Medicine, Faculty of Medicine, University of Toyama, Toyama, Toyama, Japan.
Health Administration Center, University of Toyama, Toyama, Toyama, Japan.
PLoS One. 2018 Mar 1;13(3):e0192609. doi: 10.1371/journal.pone.0192609. eCollection 2018.
Among the three adiponectin isoforms, a lower ratio of high molecular weight (HMW) adiponectin to total adiponectin (TA) is well known to cause insulin resistance and type 2 diabetes (T2D). However, how the levels of other adiponectin isoforms, such as the middle molecular weight (MMW) and low molecular weight (LMW) isoforms, and their relative ratio to TA change in T2D subjects has not been determined. Therefore, we investigated the association of these adiponectin-related parameters with T2D.
We examined the associations between adiponectin-related parameters and diabetes in a group of 394 T2D subjects and 374 controls (1st group) randomly selected from among the participants in our previous study. The associations between these parameters and the HOMA-IR in a 2nd group, consisting of the subjects remaining in the 1st group after the exclusion of subjects receiving diabetic medication, were also examined.
In the 1st group, after adjusting for confounding factor, the levels of all the adiponectin isoforms and the HMW/TA ratio were significantly lower among the diabetic subjects than among the controls (all P values < 0.01). On the contrary, the LMW/TA ratio was significantly higher among the diabetic subjects (P < 0.01) and was positively associated with T2D (odds ratio = 8.64, P < 0.01). In the 2nd group, the HMW/TA ratio was inversely associated with the HOMA-IR; however, the LMW/TA ratio was positively associated with the HOMA-IR (β for LMW/TA ratio = 0.89, SE = 0.24, P < 0.001), similar to the association with T2D. The MMW/TA ratio was not associated with T2D or the HOMA-IR.
The current investigation demonstrated that, unlike the reduction in the levels of all the adiponectin isoforms and the HMW/TA ratio, an increased LMW/TA ratio was associated with T2D through its relation to insulin resistance.
在三种脂联素异构体中,高分子量(HMW)脂联素与总脂联素(TA)的比值较低与胰岛素抵抗和 2 型糖尿病(T2D)密切相关。然而,T2D 患者中其他脂联素异构体(如中分子量(MMW)和低分子量(LMW)异构体)的水平及其与 TA 的相对比值如何变化尚未确定。因此,我们研究了这些脂联素相关参数与 T2D 的关系。
我们在我们之前研究的参与者中随机选择的 394 名 T2D 患者和 374 名对照者(第 1 组)中,检查了脂联素相关参数与糖尿病之间的关系。我们还检查了这些参数与第 1 组中排除接受糖尿病药物治疗的患者后剩余的受试者的 HOMA-IR 之间的关系(第 2 组)。
在第 1 组中,调整混杂因素后,糖尿病患者的所有脂联素异构体水平和 HMW/TA 比值均明显低于对照组(所有 P 值均<0.01)。相反,糖尿病患者的 LMW/TA 比值明显较高(P<0.01),并与 T2D 呈正相关(比值比=8.64,P<0.01)。在第 2 组中,HMW/TA 比值与 HOMA-IR 呈负相关;然而,LMW/TA 比值与 HOMA-IR 呈正相关(LMW/TA 比值的β=0.89,SE=0.24,P<0.001),与 T2D 的关系相似。MMW/TA 比值与 T2D 或 HOMA-IR 无关。
本研究表明,与所有脂联素异构体水平和 HMW/TA 比值降低不同,LMW/TA 比值的增加与胰岛素抵抗有关,与 T2D 相关。