Abstract
Objectives. This study examined whether the increase of adiponectin associated with extended-release (ER) niacin/laropiprant combination attenuates the adverse effect of niacin on glucose and insulin resistance in Hong Kong Chinese patients with dyslipidaemia. Methods. Patients (N = 121) were treated with ER niacin/laropiprant 1 g/20 mg for 4 weeks and then the dose was doubled for an additional 8 weeks. Measurements of fasting lipids, glucose, insulin, and adiponectin were performed at baseline and during the study. Results. There were significant (P < 0.001) increases in glucose (9.4 ± 13.1%), insulin (70.2 ± 91.0%), HOMA-IR (87.8 ± 103.9%), and adiponectin (169.3 ± 111.6%). The increase in adiponectin was significantly associated with increase in glucose (r = 0.221, P < 0.05), insulin (r = 0.184, P < 0.05), and HOMA-IR (r = 0.237, P < 0.01) and the association remained significant after adjustment for changes in body weight or body fat mass. Conclusion. Treatment with ER niacin/laropiprant led to a significant increase in adiponectin levels but worsening of glucose levels and insulin resistance, and the increase in adiponectin and insulin resistance were correlated suggesting the increase in adiponectin did not ameliorate the deterioration in insulin resistance. Clinical trial is registered with number on WHO-ICTRP: ChiCTR-ONC-10001038.
Highlights
Adiponectin is an adipocytokine with anti-inflammatory, antiatherogenic, and insulin-sensitizing properties, which is produced predominantly in white adipose tissue [1,2,3]
Niacin has a wide range of effects including increasing circulating levels of adiponectin, probably via stimulating adiponectin secretion by binding to the hydroxycarboxylic acid receptor 2 (HCAR2) receptor in adipose tissue [24, 25] and this may contribute to its Fasting glucose change from baseline (%) Homeostasis Model of Assessment-Insulin Resistance (HOMA-IR) change from baseline (%)
The present study examined whether the niacin-induced increase in adiponectin levels had any impact on the effect of niacin on plasma glucose levels and insulin resistance
Summary
Adiponectin is an adipocytokine with anti-inflammatory, antiatherogenic, and insulin-sensitizing properties, which is produced predominantly in white adipose tissue [1,2,3]. It modulates a number of metabolic processes, including glucose regulation and fatty acid oxidation. Various therapeutic approaches targeted at increasing adiponectin levels, or its activity, are being explored and some of these approaches have achieved therapeutic benefits in animal models of metabolic diseases [13].
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