Abstract
In obesity, elevated fat mass and ectopic fat accumulation are associated with changes in adipokine secretion, which may link obesity to inflammation and the development of insulin resistance. However, relationships among individual adipokines and between adipokines and parameters of obesity, glucose metabolism or inflammation are largely unknown. Serum concentrations of 20 adipokines were measured in 141 Caucasian obese men (n = 67) and women (n = 74) with a wide range of body weight, glycemia and insulin sensitivity. Unbiased, distance-based hierarchical cluster analyses were performed to recognize patterns among adipokines and their relationship with parameters of obesity, glucose metabolism, insulin sensitivity and inflammation. We identified two major adipokine clusters related to either (1) body fat mass and inflammation (leptin, ANGPTL3, DLL1, chemerin, Nampt, resistin) or insulin sensitivity/hyperglycemia, and lipid metabolism (vaspin, clusterin, glypican 4, progranulin, ANGPTL6, GPX3, RBP4, DLK1, SFRP5, BMP7, adiponectin, CTRP3 and 5, omentin). In addition, we found distinct adipokine clusters in subgroups of patients with or without type 2 diabetes (T2D). Logistic regression analyses revealed ANGPTL6, DLK1, Nampt and progranulin as strongest adipokine correlates of T2D in obese individuals. The panel of 20 adipokines predicted T2D compared to a combination of HbA1c, HOMA-IR and fasting plasma glucose with lower sensitivity (78% versus 91%) and specificity (76% versus 94%). Therefore, adipokine patterns may currently not be clinically useful for the diagnosis of metabolic diseases. Whether adipokine patterns are relevant for the predictive assessment of intervention outcomes needs to be further investigated.
Highlights
The increasing incidence of obesity and type 2 diabetes leads to severe health consequences and financial burden of health systems
Significant gender differences were detected for adiponectin, ANGPTL3, DLK1, and resistin with higher serum concentrations in women and for ANGPTL6, CTRP5, and retinol binding protein 4 (RBP4) with higher levels in men (p, 0.05; data not shown)
In addition to significant differences in glucose metabolism parameters (FPG, HbA1c, Fasting plasma insulin (FPI), Homeostatis model assessment – insulin resistance (HOMA-IR)) between type 2 diabetes (T2D) patients and controls, diagnosis of T2D was associated with significantly higher serum concentrations of ANGPTL6, Nampt, omentin, progranulin, as well as lower circulating DLK1 (Table 1)
Summary
The increasing incidence of obesity and type 2 diabetes leads to severe health consequences and financial burden of health systems. Impaired adipose tissue function - one of the primary defects in obesity – is reflected by alterations in circulating adipokines which may link obesity to inflammation, insulin resistance and cardiovascular disease [3,4,5,6]. Adipokines are involved in various metabolic processes including the regulation of appetite control, satiety, energy expenditure, insulin sensitivity, inflammation, and cardiovascular function [7,4]. Circulating adipokine patterns could be clinically relevant as markers of adipose tissue function and indicators of an increased metabolic risk [3,8]. With the expanding number of newly identified adipokines there is an increasing need to define their function, molecular targets and potential clinical relevance in the treatment of obesity and metabolic diseases
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