Issue 139 Item 14 Adiponectin Levels Influence Type 2 Diabetes Risks

Increased concentrations of adiponectin are associated with reduced risk of incident type 2 diabetes in apparently healthy individuals.

"Our results accord with those of a study in Pima Indians," declares Dr Joachim Spranger and colleagues from the Benjamin Franklin Medical Center, Free University Berlin, Germany. Both of these observations, combined with emerging functional and genetic evidence, "support the concept that adiponectin has a central role in the development of type 2 diabetes."

Adiponectin1 is exclusively and abundantly expressed in white adipose tissue and has been shown to have insulin sensitising and anti-inflammatory properties, the researchers point out. Both genetic and functional data suggest that adiponectin could be involved in the pathogenesis of type 2 diabetes.

The researchers designed a prospective, nested case-control study within the population-based European Prospective Investigation into Cancer and Nutrition Potsdam cohort, which includes 27,548 individuals aged between 35 and 65. They assessed whether baseline concentrations of adiponectin in plasma independently modify the risk of type 2 diabetes in apparently healthy individuals.

Dr Spranger and colleagues found that adiponectin concentrations in plasma were lower among individuals who later developed type 2 diabetes mean (5.34 mg/mL) than among controls (6.87 mg/mL). High concentrations of adiponectin were associated with a substantially reduced relative risk of type 2 diabetes after adjustment for age, sex, waist-to-hip ratio, body-mass index, smoking, exercise, alcohol consumption, education, and glycosylated haemoglobin A.

The researchers said that their results "suggest that adiponectin has a substantial role in the pathogenesis of type 2 diabetes, and that adiponectin could be used as an indicator of risk in addition to the established risk parameters such as obesity and physical activity." Lancet 2003;361:226-28