Increased serum adiponectin levels in type 1 diabetic patients with microvascular complications
Increased serum adiponectin levels in type 1 diabetic patients with microvascular complications
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DOI：
10.1007/s00125-005-1850-z
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发表时间：
2005-09-01
期刊：
影响因子：
8.2
通讯作者：
Flyvbjerg, A
中科院分区：
文献类型：
--
作者：
Frystyk, J;Tarnow, L;Flyvbjerg, A
目的/假设：低血清脂联素（ADPN）与2型糖尿病患者心血管疾病（CVD）和视网膜病变的风险增加相关。在1型糖尿病患者中，ADPN和血管并发症之间的关系在很大程度上是未知的。研究方法：我们研究了1型糖尿病患者血清ADPN与视网膜病变、肾病和CVD的关系，将患者分为正常白蛋白尿且无视网膜病变组（n=67）、单纯性视网膜病变组（n=106）或增殖性视网膜病变组（n=19）和单纯性肾病组（n=62）或增殖性视网膜病变组（n=137）。纳入健康对照受试者（n=25）。结果：1型糖尿病患者血清ADPN水平明显高于对照组（P < 0.0001）。肾病组血清ADPN水平明显高于非肾病组（P < 0.0001）。白蛋白尿正常的增生性视网膜病变患者也高于无增生性视网膜病变的患者（p < 0.0001）。在调整已知的危险因素后，这些差异仍然显著（p < 0.03）。CVD也与ADPN水平升高相关（p < 0.05），但在调整危险因素后，这种差异变得不显著。血清ADPN最重要的预测因子是正常白蛋白尿患者的性别（r（2）=19%）和肾病患者的GFR（r（2）=18%）。结论/解释：有微血管并发症的1型糖尿病患者血清ADPN水平高于无并发症的患者。ADPN水平升高是否与微血管并发症的发生有病理学关系，或者是一种有益的反调节反应，仍有待澄清。
Aims/hypothesis: Low serum adiponectin (ADPN) has been associated with increased risk of cardiovascular disease (CVD) and retinopathy in patients with type 2 diabetes mellitus. In type 1 diabetic patients, the relationship between ADPN and the presence of vascular complications is largely unknown. Methods: We investigated the relationship between serum ADPN and the presence of retinopathy, nephropathy and CVD in patients with type 1 diabetes, divided into matched groups with normoalbuminuria and no retinopathy (n=67), simplex retinopathy (n=106) or proliferative retinopathy (n=19), and nephropathy with simplex (n=62) or proliferative retinopathy (n=137). Healthy control subjects (n=25) were included. Results: Serum ADPN was increased in subjects with type 1 diabetes compared with control subjects (p < 0.0001). Further, serum ADPN was higher in patients with than in those without nephropathy (p < 0.0001). It was also higher in normoalbuminuric patients with than in those without proliferative retinopathy (p < 0.0001). These differences remained significant after adjustment for known risk factors (p < 0.03). CVD was also associated with elevated ADPN levels (p < 0.05), but this difference became insignificant after risk factor adjustment. The most important predictor of serum ADPN was sex (r(2)=19%) in normoalbuminuric patients and GFR in patients with nephropathy (r(2)=18%). Conclusion/interpretation: Patients with type 1 diabetes and microvascular complications have higher serum levels of ADPN than patients without complications. It remains to be clarified whether elevated levels of ADPN are pathogenically related to the development of microvascular complications or represent a beneficial counter-regulatory response.