Abstract

Adipocytokines play a major role in obesity-associated disorders like insulin resistance (IR). IR is prevalent in diabetes and advanced kidney failure. Adipolin is an adipocytokine with major beneficial effects on insulin sensitivity. This study aimed to investigate adipolin concentration and its relationship with IR and other cardiovascular risk factors in patients with diabetes and/or hemodialysis. In this preliminary study, 24 obese patients with type 2 diabetes (DM) and 30 with hemodialysis (14 with diabetes and hemodialysis (HD/DM) and 16 with hemodialysis (HD/non-DM)) were studied. Anthropometric indexes, serum concentrations of adipolin, fasting blood glucose (FBG), insulin, homeostatic model assessment of insulin resistance (HOMA-IR), and lipid profile were assessed. The results showed higher serum adipolin in DM (29 ± 35 ng/mL) than in HD/DM (13 ± 2 ng/mL, P = 0.01) and HD/Non-DM (12 ± 1.6 ng/mL, P = 0.01) groups. Insulin level was lower in DM than HD/DM (P < 0.001) and HD/Non-DM (P < 0.001) groups, and HOMA-IR was also significantly lower in DM compared to HD/DM group (P < 0.001); while, FBG was significantly higher in DM (P < 0.001) and HD/DM (P = 0.006) compared to HD/Non-DM patients. Adipolin was inversely associated with insulin level (r = -0.446, P = 0.001) and HOMA-IR (r = -0.296, P = 0.035). LDL level was higher in DM compared to HD/DM (P = 0.008) and HD/Non-DM (P = 0.005) groups. Adipolin was directly correlated with cholesterol (r = 0.348, P = 0.01) and LDL (r = 0.428, P = 0.001) concentrations. Higher adipolin level in DM group might indicate a compensatory elevation in adipolin production or secretion to modulate IR. It might also be due to medications and inflammation. Further studies are required to investigate the precise role of this adipokine in IR.

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