Abstract 17176: Adiponectin, Metabolic Factors and CRP Changes with a Lifestyle Intervention for Weight Loss in Men and Women with Diabetes: Insights From the Look Ahead (Action for Health in Diabetes) Study

Abstract

Adiponectin (ADN) has anti-inflammatory effects. In obese diabetic persons, ADN levels are low and CRP levels are high. The associations of changes in total (T) ADN and its high molecular-weight oligomer (HMW-ADN) with CRP change (Δ) in response to an intensive lifestyle intervention for weight loss (ILI) have not been examined within a clinical trial. Little is known about the effects of metabolic changes by sex on these associations in diabetes. Methods: Using regression analyses, we examined whether T-ADN and HMW-ADN changes with a 1-year ILI would be associated with CRP Δ in a subset of 1,397 Look AHEAD participants with biomarker data, when compared to usual care, after accounting for weight, HbA1c, HDL-C and fitness changes. Look AHEAD is a randomized trial examining whether ILI, when compared to usual care, will reduce CV events in obese type 2 diabetic persons. Results: ILI resulted in greater CRP reductions and increases in T-ADN and HMW-ADN, when compared to usual care (p≤ 0.0001 for all). CRP Δ with ILI was similar in men and women (≈ -40%). The increases in T-ADN and HMW-ADN were greater in men (23.6 and 13.5%) than in women (6.2% and 14.8%), respectively. Change in T-ADN and HMW-ADN in men and in T-ADN in women were significantly associated with CRP Δ, independently of weight, HDL-C, fitness and HbA1c changes (See Table). Fitness change in men and weight change in women, but not HbA1c or HDL-C changes, were associated with CRP Δ after adjusting for T-ADN and HMW-ADN change in separate models. Conclusion: In obese diabetic subjects, T-ADN and HMW-ADN are associated with changes in CRP with differential effects in male and female participants, with weight playing a greater role in women and fitness a greater role in men.