engleski

Adiponectin appears to have different mechanisms in type 1 and type 2 diabetes, with C-peptide as a common link

The study was designed to determine parameters responsible for adiponectin (ApN) modulation in patients with type 1 (DM1) (n=24) and type 2 diabetes (DM2) (n=49), and the control group (CG) (n= 28). Independent variables: C-reactive protein (CRP), fibrinogen (FIB), homocysteine (HCY), C-peptide, body mass index (BMI), fasting blood glucose (fBG), uric acid , pulse pressure (PP) and HDL-cholesterol entered the model to determine main predictors of ApN using stepwise multiple regression analysis. After stepwise multivariate regression in DM1 for ApN, the best model (R2=0.903) included BMI (p<0.0001), sex (p=0.0006) and C-peptide (p=0.0006). In DM2 the best model for ApN (R2=0.747) included HDL (p<0.0001), C-peptide (p=0.0009) and PP (p=0.013). Results of univariate regression for DM1 showed that only BMI was statistically significant (R2=0.146) for ApN (p.e.=-0.908, p=0.0371), and for DM2 that only HDL was statistically significant (R2=0.361) for ApN (p.e.=8.009, p<0.0001). ANOVA showed significant among-group differences in ApN (F=3.77, df=2, p=0.028), BMI (F=8.43, df=2, p<0.001), fBG (F=9.58, df=2, p<0.001) and HDL (F=4.60, df=2, p=0.012) according to the type of DM. Tukey post hoc test test pointed to a significant difference in ApN between DM1 (13.47&plusmn ; ; ; ; ; ; 7.45) and CG (8.00&plusmn ; ; ; ; ; ; 3.84) (p=<0.001), and DM1 and DM2 (6.08&plusmn ; ; ; ; ; ; 2.40) (p<0.001). Significant between-group differences were also observed in ApN (F=4.74, df=1, p=0.033) and HDL (F=7.05, df=1, p=0.009) according to sex. No significant differences were observed in CRP among the groups according to DM type (p=0.153) or sex (p=0.172). ApN correlated significantly (p<0.05) with BMI (r=-0.26), C-peptide (r=-0.49), PP (r=0.24) and HDL (r=0.51). In the group of patients with DM2 a significant difference was observed in CRP (p=0.001), fBG (p=0.005) and HDL (p=0.054), but not in ApN (p=0.167), according to BMI. ApN and HDL were significantly lower in men. ApN decreased in women &#8805; 50 years of age, but no such change occurred in men. HDL decreased with age in women, and increased in men, but not significantly. There was no statistical difference in BMI between men and women ; it was significantly increased in women, and insignificantly decreased in men. C-peptide was determined as an independent predictor of ApN in both types of diabetes, in addition to BMI and sex in DM1, and HDL and PP in DM2. This pointed to an interaction between islet cell function and ApN level in DM1 and DM2, but different mechanisms of ApN in different types of DM.

adiponectin; C-peptide; diabetes mellitus

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