Department of Medicine, Faculty of Medicine, Kuwait University, Safat, Kuwait.
Department of Pathology, Faculty of Medicine, Kuwait University, Safat, Kuwait.
Dis Markers. 2018 Jul 5;2018:5187940. doi: 10.1155/2018/5187940. eCollection 2018.
Adipose tissue-derived adiponectin has pleiotropic protective effects with suppression of inflammatory and metabolic derangements that may result in insulin resistance, metabolic syndrome, type 2 diabetes mellitus (T2DM), and cardiovascular disease. The aim of this study was to evaluate adiponectin as a diagnostic marker of T2DM and diabetes control.
Fasting adiponectin, insulin, glucose, and HbA1c were determined in 376 patients with known T2DM and 575 subjects with undiagnosed diabetes but with family history of T2DM. Clinical and anthropometric data were recorded. Subjects were classified on the basis of degree of adiposity, insulin resistance (IR), and achievement of target HbA1c levels. Receiver operating characteristic (ROC) curve analysis was used to examine the diagnostic performance for undiagnosed DM.
In undiagnosed subjects, adiponectin was significantly lower in subjects with IR and diabetic subjects compared with those without. The area under the adiponectin ROC curve for diagnosis of DM was 0.740. In known T2DM subjects, those with good control had significantly higher adiponectin (8.6 versus 7.4 g/mL) compared to subjects with poor control.
Adiponectin levels are associated with better glycemic control and could be a useful adjunct for screening for IR and T2DM. Therapeutic measures that increase adiponectin levels might be valuable targets for improving diabetes control and decreasing complications.
脂肪组织来源的脂联素具有多种保护作用，可抑制炎症和代谢紊乱，从而导致胰岛素抵抗、代谢综合征、2 型糖尿病（T2DM）和心血管疾病。本研究旨在评估脂联素作为 T2DM 和糖尿病控制的诊断标志物。
在已知患有 T2DM 的 376 名患者和有家族史但未诊断为糖尿病的 575 名患者中，测定空腹脂联素、胰岛素、血糖和 HbA1c。记录临床和人体测量数据。根据肥胖程度、胰岛素抵抗（IR）和达到目标 HbA1c 水平，对受试者进行分类。采用受试者工作特征（ROC）曲线分析评估诊断未诊断 DM 的性能。
在未诊断的受试者中，IR 受试者和糖尿病受试者的脂联素明显低于无 IR 受试者和无糖尿病受试者。脂联素诊断 DM 的 ROC 曲线下面积为 0.740。在已知的 T2DM 患者中，血糖控制良好的患者的脂联素明显高于血糖控制不佳的患者（8.6 对 7.4μg/ml）。
脂联素水平与更好的血糖控制相关，可能是筛查 IR 和 T2DM 的有用辅助手段。增加脂联素水平的治疗措施可能是改善糖尿病控制和减少并发症的有价值目标。
