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Relationship between adiponectin level, insulin sensitivity and metabolic syndrome in type 1 diabetic patients

Objective: Adiponectin is known to be decreased in insulin resistance (IR) and metabolic syndrome (MS). MS can be present in patients with type 1 diabetes mellitus (T1DM) representing an independent risk factor for micro- and macrovascular complications. The aim of this study was to evaluate the relationship between adiponectin level, MS, and insulin sensitivity in T1DM patients. Research design and methods: Study included 77 T1DM patients divided into two groups based on the median adiponectin value (14.1 µg/ml). Insulin sensitivity was calculated with the equation for eGDR: 24.31–12.2X(WHR)– 3.29X(AHT)–0.57X(HbA1c), where the units are mgkg– 1min–1, WHR indicates the waist to hip ratio, AHT indicates blood pressure, and is expressed as: 0- no, 1-yes. MS was defined both according to National Cholesterol Education Program’s Adult Treatment Panel III report (ATP III) and International Diabetes Federation (IDF) criteria. Results: Patients with higher adiponectin levels (n=39) in comparison with the group with lower adiponectin (n=38) had significantly lower waist circumference (80.9 vs 90.5 cm, p<0.002), fasting venous glucose levels (6.80 vs 8.45 mmol/L, p<0.001) higher HDL3-cholesterol (1.23 vs 1.06 mmol/L, p=0.011) and eGDR (7.67 vs 6.06 mgkg–1min– 1, p=0.003). Patients with lower adiponectin levels showed higher incidence of MS following ATPIII (50 vs 33.3%, p=NS) and IDF definition (44.7 vs 23.1 %, p=NS) in comparison to those with higher adiponectin levels. In the univariate binary logistic regression model adiponectin was significantly associated with insulin sensitivity, while in the multivariate binary logistic regression model adiponectin was significantly inversely associated with the presence of MS. Conclusion: Higher adiponectin level is associated with lower incidence of MS in type 1 diabetic patients. Whether higher adiponectin level has a protective role in the development of the MS in type 1 diabetes needs to be clarified in future follow-up studies.

adiponectin; metabolic syndrome; type 1 diabetes; insulin sensitivity

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