Adiponectin dysregulation and insulin resistance in type 1 diabetes

RI Pereira, JK Snell-Bergeon, C Erickson…�- The Journal of�…, 2012 - academic.oup.com
RI Pereira, JK Snell-Bergeon, C Erickson, IE Schauer, BC Bergman, M Rewers, DM Maahs
The Journal of Clinical Endocrinology & Metabolism, 2012academic.oup.com
Context: Type 1 diabetes (T1D) is associated with insulin resistance despite elevated levels
of the insulin-sensitizing protein adiponectin. Whether the expected positive correlation
between adiponectin and insulin sensitivity is preserved in a T1D population is unknown.
Objective: We measured the correlation between total and high-molecular-weight (HMW)
adiponectin and insulin sensitivity in T1D patients and nondiabetic controls and identified
determinants of adiponectin levels in patients with T1D. Design and Participants: Fasting�…
Context
Type 1 diabetes (T1D) is associated with insulin resistance despite elevated levels of the insulin-sensitizing protein adiponectin. Whether the expected positive correlation between adiponectin and insulin sensitivity is preserved in a T1D population is unknown.
Objective
We measured the correlation between total and high-molecular-weight (HMW) adiponectin and insulin sensitivity in T1D patients and nondiabetic controls and identified determinants of adiponectin levels in patients with T1D.
Design and Participants
Fasting total and HMW adiponectin were measured in 86 subjects from the Coronary Artery Calcification in T1D (CACTI) cohort (39 T1D, 47 nondiabetic; age 45 � 8 yr; 55% female). The association of adiponectin levels with insulin sensitivity was analyzed.
Setting
The study was conducted at an academic research institute.
Methods
Fasting total and HMW adiponectin were measured by RIA and ELISA, respectively. Insulin sensitivity was measured by a hyperinsulinemic-euglycemic clamp. Multivariate linear regression was used to identify determinants of adiponectin levels.
Results
Adiponectin levels positively correlated with insulin sensitivity in both subject groups (total adiponectin, r = 0.33 P < 0.05 for T1D, r = 0.29 P < 0.05 controls), but insulin sensitivity was lower in T1D subjects at any given level of total or HMW adiponectin. Adiponectin levels were independently associated with age, gender, and trunk fat, but these variables did not account for increased adiponectin in patients with T1D.
Conclusion
Adiponectin levels are positively correlated with insulin sensitivity in T1D patients. However, T1D patients have decreased insulin sensitivity compared with controls at every level of adiponectin, suggesting an important adaptive change of adiponectin set point.
Oxford University Press