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Submitted on May 18, 2005
Accepted on October 4, 2005
Department of Clinical Chemistry and Internal Medicine VU University Medical Center and Institute for Cardiovascular Research Vrije Universiteit, Amsterdam, the Netherlands. International Centre for Circulatory Health & National Heart & Lung Institute, Imperial College London, London, UK. Department of Epidemiology and Public-Health, Royal Free and University College London Medical School, London, UK. Current address: Department of Medicine, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands
* To whom correspondence should be addressed. E-mail: C.Schalkwijk{at}intmed.unimaas.nl.
Objective: Adipose tissue is a source of several adipocytokines that may contribute to vascular complications. We examined the relation of adiponectin with several cardiovascular risk factors and with micro and macrovascular outcomes in type 1 diabetic patients.
Design: Cross-sectional data on 543 Type 1 diabetic patients from the EURODIAB Prospective Complications Study were analyzed. We determined adiponectin, TNF-
, IL-6, C-reactive protein, sVCAM-1and sE-selectin by ELISA.
Results: We found that adiponectin was negatively correlated with BMI, waist-to-hip ratio, insulin and fasting triglyceride, and positively with HDL, LDL and total cholesterol, TNF- and sVCAM-1, but was not related to C-reactive protein, IL-6 and sE-selectin. Surprisingly, significantly raised concentrations of adiponectin were found with albuminuria, retinopathy and cardiovascular diseases (CVD) (for all, p-values <0.0001). Adiponectin levels were inversely associated with glomerular filtration rate (GFR) (P < 0.0001). Multivariate regression models showed that the associations of adiponectin with albuminuria and GFR were independent of established risk factors. The association between adiponectin and albuminuria was attenuated by GFR, whereas the association of adiponectin with retinopathy and CVD disappeared after adjustments for established risk factors. The association of adiponectin with sVCAM-1 was independent of established risk factors.
Conclusion: We conclude that in type 1 diabetic patients adiponectin is associated with impaired renal function. Adiponectin may be enhanced in type 1 diabetic patients as a physiological counter-regulatory response to mitigate endothelial damage and vascular damage.
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