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

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. Study included 77 T1DM patients divided into two groups based on the total adiponectin median 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 according to International Diabetes Federation (IDF) criteria. 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 mg/kg–1min–1, p=0.003). Patients with lower adiponectin levels showed higher prevalence of MS following IDF definition (44.7 vs 23.1 %, p=0.045) in comparison to those with higher adiponectin concentrations. eGDR increased for 1.09 (CI 1.03-1.16) mg/kg–1min–1, p=0.003 by each increase of 1 µg/ml total fasting plasma adiponectin. In the multivariate binary logistic regression model adiponectin was significantly independently inversely associated with the presence of MS (OR 0.89, p=0.014). Higher adiponectin concentration is associated with lower prevalence of MS in T1DM patients. Whether higher adiponectin concentration has a protective role in the development of the MS in T1DM needs to be clarified in future follow-up studies.

adiponectin; metabolic syndrome; type 1 diabetes; insulin sensitivity

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