Impact of adiposity and plasma adipocytokines on diabetic angiopathies in Japanese Type 2 diabetic subjects
Impact of adiposity and plasma adipocytokines on diabetic angiopathies in Japanese Type 2 diabetic subjects
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DOI：
10.1111/j.1464-5491.2004.01261.x
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发表时间：
2004-08-01
影响因子：
3.5
通讯作者：
Kaku, K
中科院分区：
文献类型：
--
作者：
Matsuda, M;Kawasaki, F;Kaku, K
目的脂肪细胞因子是脂肪组织的产物，对血管系统具有生物学活性，可能影响糖尿病血管病变。在这项研究中，我们评估了肥胖和血浆脂肪细胞因子水平之间的关系，并调查了肥胖和血浆脂肪细胞因子水平对2型糖尿病患者的糖尿病微血管和大血管病变的临床意义。（135名男性和96名女性，年龄60.4 ± 12.3岁，体重指数24.8 ± 5.2 kg/m（2））。我们测量了脂肪细胞因子[脂联素、瘦素、瘦素和肿瘤坏死因子（TNF）-α]水平、血脂谱和尿白蛋白排泄。我们也进行眼底检查，并使用B型超音波测量颈动脉中层厚度（IMT），并使用腹部电脑断层扫描定位脂肪。一组93例微量白蛋白尿或明显蛋白尿的受试者与其他148例受试者进行比较，以评估对肾病的影响。结果血浆脂联素水平与内脏脂肪面积（r =-0.37，P < 0.01）和皮下脂肪面积（r =-0.25，P <0.01）呈负相关。抵抗素浓度与内脏脂肪面积呈正相关（r = 0.15，P < 0.05）。脂联素水平与年龄呈正相关（r = 0.26，P < 0.01）。经年龄校正后，TNF-α与IMT相关（r = 0.16，P < 0.05）。Logistic回归分析表明，一个单位增加TNF-α（pmol/l）和一个单位增加瘦素（nmol/l）的肾病的机会增加了4085倍，30.64倍。结论目前的观察表明，内脏和皮下脂肪对微血管病变以及大血管病变的影响，可能通过不同的脂肪细胞因子。
Aims Adipocytokines, products from adipose tissue, have biological activities on the vascular system, and may affect diabetic angiopathy. In this study, we assessed the relationship between adiposity and plasma adipocytokine levels, and investigated the clinical significance of adiposity and plasma adipocytokine levels on diabetic micro- and macroangiopathy in Type 2 diabetic subjects.Methods We studied 231 Japanese Type 2 diabetic subjects (135 men and 96 women, aged 60.4 +/- 12.3 years, body mass index 24.8 +/- 5.2 kg/m(2)). We measured adipocytokine [adiponectin, leptin, resistin, and tumour necrosis factor (TNF)-alpha] levels, lipid profiles and urine albumin excretion. We also performed optic fundus examination and measured carotid intramedia thickness (IMT) using B-mode ultrasonography, and the localization of fat with abdominal computed tomography. A group of 93 subjects with microalbuminuria or overt proteinuria was compared with the other 148 to assess the effect on nephropathy. A group of 191 eyes with simple retinopathy or more advanced changes was compared with 263 eyes without retinal changes to assess the effect on retinopathy.Results Plasma adiponectin level was negatively correlated with both visceral (r = -0.37, P < 0.01) and subcutaneous (r = -0.25, P < 0.01) fat areas. Resistin concentration was positively related with visceral fat area (r = 0.15, P < 0.05). Adiponectin concentration was positively correlated with age (r = 0.26, P < 0.01). TNF-alpha was correlated with IMT (r = 0.16, P < 0.05) after correction for age. Logistic regression analysis indicates a 4085 times greater chance of having retinopathy with a one unit increase in TNF-alpha (pmol/l) and a 30.64 times greater chance of having nephropathy with one unit increase in leptin (nmol/l).Conclusions The present observations suggest that visceral and subcutaneous fat has an impact on microangiopathy as well as macroangiopathy, possibly through different adipocytokines.