An association between adiponectin and renal dysfunction in patients with type 2 diabetes mellitus

Česká verzia

Authors: A. Galovičová ¹; I. Lazúrová ¹; D. Petrášová ²
Authors place of work: I. interná klinika Lekárskej fakulty UPJŠ a UN L. Pasteura Košice, Slovenská republika, prednostka prof. MUDr. Ivica Lazúrová, CSc. ¹; Ústav experimentálnej medicíny Lekárskej fakulty UPJŠ Košice, Slovenská republika, prednosta MVDr. Alojz Bomba, DrSc. ²
Published in the journal: Vnitř Lék 2012; 58(11): 825-829
Category: Original Contributions

Summary

Introduction:
Adiponectin is a hormone of adipose tissue produced exlusively by adipocytes. According to recent studies its serum concentrations are negatively associated with obesity and diabetes mellitus type 2 (DM).

The aim of the study was to clarify the relationship between renal functions and serum adiponectin in patients suffering from diabetic nephropathy.

Patients and methods:
The serum adiponectin levels were investigated in 120 patients and 40 controls. Patients in the diabetic group were divided according to albumin excretion rate into three groups – with normoalbuminuria (AER – albumin excretion rate/24 hod < 30 mg/24 h), with microalbuminuria (AER 30 ≤ 300 mg/24 h) and with macroalbuminuria (AER > 300 mg/24 h).

Results:
Serum adiponectin levels in diabetic group did not show any significant difference as compared with the control group. The highest concentrations of adiponectin were observed in patients with macroalbuminuria 24.22 ± 10.37 µg/ml (p < 0.0001) compared to those with normoalbuminuria and microalbuminuria, or control group, which was significant. Patients with normoalbuminuria 12.16 ± 5.3 µg/ml had the lowest concentrations of adiponectin. The univariate linear regression analysis revealed the negative correlation with BMI (r = –0.4, p < 0.0001) and glomerular filtration (r = –0.2, p < 0.05) and positive correlation with albuminuria (r = 0.5, p < 0.0001). Multiple linear regression confirmed that BMI and AER are independent predictive factors of adiponectin levels as well as that adiponectin and glomerular filtration are independent predictors of albuminuria.

Conclusion:
The beginning and progress of diabetic nephropathy play probably one of the most important roles in increased synthesis and excretion of adiponectin to blood circulation by diabetic patients with overt diabetic nephropathy.

Key words:
diabetes mellitus type 2 – adiponectin – obesity – diabetic nephropathy

Zdroje

1. Ukropcová B, Ukropec J, Klimeš I et al. Endokrinná funkcia tukového tkaniva. Via pract 2008; 5: 115–121.

2. Zoccali C, Mallamaci F. Obesity, diabetes, adiponectin and the kidney: a podocyte affair. Nephrol Dial Transplant 2008; 23: 3767–3770.

3. Tajtáková M, Petrášová D, Pidaniová A et al. Serum levels of leptin, adiponectin, retinol binding protein 4 and leptin/adiponectin molar ratio as another possible marker of insulin resistance in obese. Bratisl Lek Listy 2010; 111: 212–215.

4. Monzillo LU, Hamdy O, Horton ES et al. Effect of lifestyle modification on adipokine levels in obese subjects with insulin resistance. Obes Res 2003; 11: 1048–1054.

5. Kumada M, Kihara S, Sumitsuji S et al. Association of hypoadiponectinemia with coronary artery disease in men. Arteriosler Thromb Vasc Biol 2003; 23: 85–89.

6. Pischon T, Girman CJ, Hotamisligil GS et al. Plasma adiponectin level and risk of myocardial infarction in men. JAMA 2004; 291: 1730–1737.

7. Schulze MB, Shai I, Rimm EB et al. Adiponectin and future coronary heart disease events among men with type 2 diabetes. Diabetes 2005; 54: 534–539.

8. Hotta K, Funahashi T, Arita Y. Plasma concentrations of a novel, adipose specific protein, adiponectin in type 2 diabetic patients. Arterioscler Thromb Vasc Biol 2000; 20: 1595–1599.

9. Im JA, Kim SH, Lee JW et al. Association between hypoadiponectinemia and cardiovascular risk factors in nonobese healthly adults. Metabolism 2006; 55: 1546–1550.

10. Koenig W, Khuseyinova N, Baumert J et al. Serum concentrations of adiponectin and risk of type 2 diabetes mellitus and coronary heart disease in apparently healthly middle-aged men: results from the 18-year follow-up of large cohort from southern Germany. J Am Coll Cardiol 2006; 48: 1369–1377.

11. Monhart V. Mikroalbuminurie. Od diabetu ke kardiovaskulárnímu riziku. Vnitř Lék 2011; 57: 293–298.

12. Koshimura J, Fujita H, Narita T et al. Urinary adiponectin excretion is increased in patient with overt diabetic nephrophaty. Bioch Biophys Res Commun 2004; 316: 165–169.

13. Looker HC, Krakoff J, Funahashi Y et al. Adiponectin concentrations are influenced by renal function and diabetes duration in Pima Indians with type 2 diabetes. J Clin Endocrinol Metab 2004; 89: 4010–4017.

14. Fujita H, Morii T, Koshimura J et al. Possible relationship between adiponectin and tubular injury in diabetic nephropathy. Endocrin Journal 2006; 53: 745–752.

15. Komaba H, Igaki N, Goto S et al. Increased serum high molecular weight complex of adiponectin in type 2 diabetic patients with impaired renal function. Am J Nephrol 2006; 26: 476–482.

16. Iwashima Y, Horio T, Kumada M et al. Adiponectin and renal function, and implication as risk of cardiovascular disease. Am J Cardiol 2006; 98: 1603–1608.

17. Dabla PK. Renal function in diabetic nephropathy. World J Diabetes 2010; 1: 48–56.

18. Saito T, Saito O, Kawano T et al. Elevation of serum adiponectin and CD 146 levels in diabetic nephropathy. Diabetes Res Clin Pract 2007; 78: 85–92.

19. Saraheimo M, Forsblom C, Fagerudd J et al. Serum adiponectin is increased in type 1 diabetic patient with nephropathy. Diabetes Care 2005; 28: 1410–1414.

20. Guebre-Egziabher F, Bernhard J, Funahashi T et al. Adiponectin in chronic kidney disease is related more to metabolic disturbances than to decline in renal function. Nephrol Dial Transplant 2005; 20: 129–134.

21. Lin J, Hu FB, Curhan G et al. Serum adiponectin and renal dysfunction in men with type 2 diabetes. Diabetes Care 2007; 30: 239–244.

22. Yenicesu M, Yilmaz MI, Caglar K et al. Adiponectin level is reduced and inversly correlated with degree of proteinuria in type 2 diabetic patients. Clin Nephrol 2005; 64: 9–12.

23. Yenicesu M, Yilmaz MI, Caglar K et al. Blockade of the renin-angiotensin system increased plasma adiponectin levels in type 2 diabetic patients with proteinuria. Nephron Clin Pract 2005; 99: 115–121.

24. Hadjadj S, Aubert R, Fumeron F et al. Increased plasma adiponectin concentrations are associated with microangiopathy in type 1 diabetic subjects. Diabetologia 2005; 48: 1088–1092.