Changes in adiponectin level and fat distribution in patients with type 2 diabetes

Abstract

The aim of this study was to assess the impact of standard hypoglycaemic treatment strategies on adiponectin levels and fat distribution in patients with newly diagnosed type 2 diabetes mellitus (T2DM). This was a prospective observational study of 50 women with newly diagnosed T2DM, aged 64·6±7·9years and treated for 12months with lifestyle modification alone (n=24) or in combination with metformin (n=26), according to current standards of diabetic care and clinical practice guidelines. None of the patients required insulin therapy during the entire study period. Total (BF), abdominal (android) and hip (gynoid) fat were measured by dual-energy X-ray absorptiometry at the baseline and after 12months of treatment. Total adiponectin, glycated haemoglobin (HbA1c) and fasting glucose were measured in 3-month intervals. Baseline adiponectin level was low (9·37±2·81μg/mL). Lifestyle modifications and metformin produced comparable changes in adiponectin levels, which were not associated with changes in BF, HbA1c, glucose and regional fat depots. Baseline adiponectin was inversely correlated with triglycerides (R=-0·441; P=0·0007) and the android/gynoid ratio (R=-0·272; P=0·042). Treatment with metformin was associated with a significant weight reduction (P=0·033), which resulted from a decrease in BF% (P=0·044) but was not associated with changes in android and gynoid depots. In postmenopausal women with newly diagnosed T2DM, lifestyle modifications alone or combined with metformin produced comparable changes in adiponectin levels. Weight reduction in patients treated with metformin was associated with significant decrease in %BF but not in regional fat depots.