Kim Min-Ji, Kim Sung-Woo, Ha Bitna, Kim Hyang Sook, Kwon So-Hee, Jin Jonghwa, Choi Yeon-Kyung, Park Keun-Gyu, Kim Jung Guk, Lee In-Kyu, Jeon Jae-Han
Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
Department of Internal Medicine, Daegu Catholic University Hospital, Daegu Catholic University School of Medicine, Daegu, Korea.
Korean J Intern Med. 2025 Mar;40(2):299-309. doi: 10.3904/kjim.2024.221. Epub 2025 Mar 1.
BACKGROUND/AIMS: Adiponectin, a hormone primarily produced by adipocytes, typically shows an inverse relationship with body mass index (BMI). However, some studies have reported a positive correlation between the two. Thus, this study aimed to examine the relationship between adiponectin level and BMI in diabetic patients, focusing on the impact of past obesity on current adiponectin levels.
We conducted an observational study analyzing data from 323 diabetic patients at Kyungpook National University Hospital. Based on past and current BMIs, participants were categorized into never-obese (nn, n = 106), previously obese (on, n = 43), and persistently obese (oo, n = 73) groups based on a BMI threshold of 25 kg/m2. Adiponectin level and BMI were key variables. Kaplan-Meier analysis assessed their impact on all-cause mortality up to August 2023, with survival differences based on adiponectin quartiles and follow-up starting from patient enrollment (2010-2015).
The analysis revealed a significant inverse correlation between adiponectin level and past maximum BMI. The on group exhibited approximately 10% lower adiponectin levels compared to the nn group. This association remained significant after adjusting for current BMI, age, and sex, highlighting the lasting influence of previous obesity on adiponectin levels. Furthermore, survival analysis indicated that patients in the lowest adiponectin quartile had reduced survival, with a statistically significant trend (p = 0.062).
Findings of this study suggest that lower adiponectin levels, potentially reflecting past obesity, are associated with decreased survival in diabetic patients, underscoring a critical role of adiponectin in long-term health outcomes.
背景/目的：脂联素是一种主要由脂肪细胞产生的激素，通常与体重指数（BMI）呈负相关。然而，一些研究报告了两者之间的正相关关系。因此，本研究旨在探讨糖尿病患者脂联素水平与BMI之间的关系，重点关注既往肥胖对当前脂联素水平的影响。
我们进行了一项观察性研究，分析了庆北国立大学医院323例糖尿病患者的数据。根据既往和当前的BMI，参与者根据25kg/m²的BMI阈值被分为从未肥胖组（nn，n = 106）、既往肥胖组（on，n = 43）和持续肥胖组（oo，n = 73）。脂联素水平和BMI是关键变量。Kaplan-Meier分析评估了它们对截至2023年8月的全因死亡率的影响，根据脂联素四分位数和从患者入组（2010 - 2015年）开始的随访来分析生存差异。
分析显示脂联素水平与既往最高BMI之间存在显著负相关。与nn组相比，on组的脂联素水平低约10%。在调整了当前BMI、年龄和性别后，这种关联仍然显著，突出了既往肥胖对脂联素水平的持久影响。此外，生存分析表明，脂联素四分位数最低的患者生存率降低，具有统计学意义的趋势（p = 0.062）。
本研究结果表明，较低的脂联素水平可能反映既往肥胖，与糖尿病患者生存率降低有关，强调了脂联素在长期健康结局中的关键作用。
