Adiponectin Dysregulation and Insulin Resistance in Type 1 Diabetes
Adiponectin Dysregulation and Insulin Resistance in Type 1 Diabetes
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DOI：
10.1210/jc.2011-2542
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发表时间：
2012-04-01
影响因子：
5.8
通讯作者：
Maahs, David M.
中科院分区：
文献类型：
--
作者：
Pereira, Rocio I.;Snell-Bergeon, Janet K.;Maahs, David M.
背景：1型糖尿病（T1 D）与胰岛素抵抗有关，尽管胰岛素增敏蛋白脂联素水平升高。脂联素和胰岛素敏感性之间预期的正相关性是否在T1 D人群中保留尚不清楚。目的：我们测量了T1 D患者和非糖尿病对照组中总脂联素和高分子量（HMW）脂联素与胰岛素敏感性之间的相关性，并确定了T1 D患者脂联素水平的决定因素。设计和参与者：对来自T1 D冠状动脉钙化（CACTI）队列的86名受试者（39名T1 D患者，47名非糖尿病患者;年龄45 ± 8岁; 55%为女性）进行了空腹总脂联素和HMW脂联素测定。方法：采用放射免疫分析法（RIA）和酶联免疫吸附法（ELISA）分别测定空腹总脂联素和高分子量脂联素（HMW）水平，并分析脂联素水平与胰岛素敏感性的关系。胰岛素敏感性通过高胰岛素-正葡萄糖钳夹来测量。结果：脂联素水平与胰岛素敏感性呈正相关（总脂联素，T1 D组r = 0.33 P < 0.05，对照组r = 0.29 P <0.05），但T1 D组在总脂联素或高分子量脂联素水平下胰岛素敏感性较低。脂联素水平与年龄、性别和躯干脂肪独立相关，但这些变量不能解释T1 D患者脂联素水平升高的原因。结论：T1 D患者脂联素水平与胰岛素敏感性呈正相关。然而，与对照组相比，T1 D患者在每个脂联素水平上的胰岛素敏感性降低，表明脂联素设定点的重要适应性变化。（临床内分泌代谢杂志97：E642-E647，2012）
Context: Type 1 diabetes (T1D) is associated with insulin resistance despite elevated levels of the insulin-sensitizing protein adiponectin. Whether the expected positive correlation between adiponectin and insulin sensitivity is preserved in a T1D population is unknown.Objective: We measured the correlation between total and high-molecular-weight (HMW) adiponectin and insulin sensitivity in T1D patients and nondiabetic controls and identified determinants of adiponectin levels in patients with T1D.Design and Participants: Fasting total and HMW adiponectin were measured in 86 subjects from the Coronary Artery Calcification in T1D (CACTI) cohort (39 T1D, 47 nondiabetic; age 45 +/- 8 yr; 55% female). The association of adiponectin levels with insulin sensitivity was analyzed.Setting: The study was conducted at an academic research institute.Methods: Fasting total and HMW adiponectin were measured by RIA and ELISA, respectively. Insulin sensitivity was measured by a hyperinsulinemic-euglycemic clamp. Multivariate linear regression was used to identify determinants of adiponectin levels.Results: Adiponectin levels positively correlated with insulin sensitivity in both subject groups (total adiponectin, r = 0.33 P < 0.05 for T1D, r = 0.29 P < 0.05 controls), but insulin sensitivity was lower in T1D subjects at any given level of total or HMW adiponectin. Adiponectin levels were independently associated with age, gender, and trunk fat, but these variables did not account for increased adiponectin in patients with T1D.Conclusion: Adiponectin levels are positively correlated with insulin sensitivity in T1D patients. However, T1D patients have decreased insulin sensitivity compared with controls at every level of adiponectin, suggesting an important adaptive change of adiponectin set point. (J Clin Endocrinol Metab 97: E642-E647, 2012)