Lower Adiponectin Values Research Articles

Adipokines as Potential Biomarkers in the Neurorehabilitation of Obese Stroke Patients.

Limited studies concern the influence of obesity-induced dysregulation of adipokines in functional recovery after stroke neurorehabilitation. To investigate the relationship between serum leptin, resistin, and adiponectin and functional recovery before and after neurorehabilitation of obese stroke patients. The adipokine potential significance as prognostic markers of rehabilitation outcomes was also verified. Twenty obese post-acute stroke patients before and after neurorehabilitation and thirteen obese volunteers without-stroke, as controls, were examined. Adipokines were determined by commercially available enzyme-linked immunosorbent assay (ELISA) kits. Functional deficits were assessed before and after neurorehabilitation with the Barthel Index (BI), modified Rankin Scale (mRS), and Functional Independence Measure (FIM). Compared to controls, higher leptin and resistin values and lower adiponectin values were observed in stroke patients before neurorehabilitation and no correlations were found between adipokines and clinical outcome measures. Neurorehabilitation was associated with improved scores of BI, mRS, and FIM. After neurorehabilitation, decreased values of Body Mass Index (BMI) and resistin together increased adiponectin were detected in stroke patients, while leptin decreased but not statistically. Comparing adipokine values assessed before neurorehabilitation with the outcome measures after neurorehabilitation, correlations were observed for leptin with BI-score, mRS-score, and FIM-score. No other adipokine levels nor BMI assessed before neurorehabilitation correlated with the clinical measures after neurorehabilitation. The forward stepwise regression analysis identified leptin as prognostic factor for BI, mRS, and FIM. Our data show the effectiveness of neurorehabilitation in modulating adipokines levels and suggest that leptin could assume the significance of biomarker of functional recovery.

Plasma Adipokines Profile in Prepubertal Children with a History of Prematurity or Extrauterine Growth Restriction.

Adipose tissue programming could be developed in very preterm infants with extrauterine growth restriction (EUGR), with an adverse impact on long-term metabolic status, as was studied in intrauterine growth restriction patterns. The aim of this cohort study was to evaluate the difference in levels of plasma adipokines in children with a history of EUGR. A total of 211 school age prepubertal children were examined: 38 with a history of prematurity and EUGR (EUGR), 50 with a history of prematurity with adequate growth (PREM), and 123 healthy children born at term. Anthropometric parameters, blood pressure, metabolic markers and adipokines (adiponectin, resistin, leptin) were measured. Children with a history of EUGR showed lower values of adiponectin (μg/mL) compared with the other two groups: (EUGR: 10.6 vs. PREM: 17.7, p < 0.001; vs. CONTROL: 25.7, p = 0.004) and higher levels of resistin (ng/mL) (EUGR: 19.2 vs. PREM: 16.3, p =0.007; vs. CONTROL: 7.1, p < 0.001. The PREM group showed the highest values of leptin (ng/mL), compared with the others: PREM: 4.9 vs. EUGR: 2.1, p = 0.048; vs. CONTROL: 3.2, p = 0.029). In conclusion, EUGR in premature children could lead to a distinctive adipokines profile, likely associated with an early programming of the adipose tissue, and likely to increase the risk of adverse health outcomes later in life.

P5295Stable and temporal metabolically benign obesity and cardiovascular disease onset in males and females: the missing link with adiponectin

Abstract Background/Introduction Metabolically healthy obesity (MHO) status has been recently conferred to be a transient condition with cohorts revealing that a considerable proportion, from 33% to 52%, lose their status over time. Purpose To evaluate the stability of MHO, its effect on 10-year first fatal/non fatal CVD onset and the mediating effect of adiponectin. Methods A prospective study was conducted during 2001–2012 studying n=1,514 males and n=1,528 females (aged &gt;18 years old) free of CVD. Follow-up CVD assessment (2011–2012) was achieved in n=2,020 participants; of them, n=317 incident cases were identified. Obesity was defined as body mass index≥30kg/m2 and healthy metabolic status as absence of all NCEP ATP III (2005) metabolic syndrome components (excluding waist circumference). Circulating adiponectin level was measured at baseline (4.0 (2.0) μg/mL). Results MHO prevalence reached 4.8% (n=146) (4.9% in males and 4.7% in females, p=0.198). 28.2% of obese participants presented a metabolically benign status at baseline. In the 5-year follow-up period, transition to metabolically unhealthy status was observed for 33% of MHO participants. Within the decade, almost half of MHO participants resulted as metabolically unhealthy obese. Unadjusted analysis revealed that stable vs. temporal MHO subjects had better lifestyle (i.e. higher adherence to Mediterranean diet and better physical activity status) at the recruitment (all ps&lt;0.05). Temporal MHO subjects presented lower adiponectin values (2.8 (1.1) μg/mL) compared with their stable MHO counterparts (4.1 (1.9) μg/mL) (p&lt;0.05). Multivariate Cox regression analysis revealed no significant discrepancies on 10-year CVD risk between MHO and metabolically healthy non-obese subjects (Hazard Ratio (HR)=0.95, 95% Confidence Interval (95% CI) 0.37, 2.08, p=0.32). Only the subset of temporal MHO subjects reached the level of significance (HR=1.43, 95% CI 1.02, 2.01, p=0.04). Stable MHO status was not independently associated with 10-year CVD risk (p&gt;0.05). Low vs. high adiponectin level was associated with ∼1.3 times higher 10-year risk to move from MHO to metabolically unhealthy obesity status (HR=1.33 95% CI 1.10, 4.02). Sensitivity analyses revealed that adiponectin had a significant interacting effect on the examined associations (p for interaction=0.01); stratified analysis using the mean value of adiponectin to define the strata revealed that MHO (stable or temporal) status was positively associated with 10-year CVD event only in participants with low adiponectin levels i.e. below the mean value of 4.1 μg/mL (HR=1.45 95% CI 1.19, 3.68). Conclusions Weight management is needed to prevent cardiometabolic features even in participants with increased weight status with healthy metabolic status. It is noteworthy that adiponectin may be an underlying path of the stability and CVD risk corresponding to this intermediate condition probably related with insulin resistance and other relevant paths. Acknowledgement/Funding The ATTICA study is supported by research grants from the Hellenic Cardiology Society [HCS2002] and the Hellenic Atherosclerosis Society [HAS2003].

2461-PUB: Increased Apolipoprotein A1 Can Suggest the Presence of Latent Autoimmune Diabetes and a Lower Cardiovascular Risk Compared with Type 2 Diabetes

Latent autoimmune diabetes (LADA) could be misdiagnosed as type 2 diabetes (DM2). Lipids, apolipoproteins, adiponectin (APN), interleukin-6 (IL-6), homocysteine (HCY), other markers of DM, including antibodies, were tested in 276 patients with DM1, DM2 and LADA. Quartiles of lipid accumulation product (LAP) (Q1:≤21.23, Q2:(21.23, 40.69], Q3:(40.69, 92.02], Q4:&amp;gt;92.02) were calculated as: [waist (cm) - 65 for men/58 for women] x triglycerides (mmol/L)]. In all statistical tests: ANOVA and Tukey post hoc test, and stepwise multivariate regression, α=0.05 was considered statistically significant. ANOVA revealed significant differences in HCY, APN, IL-6 and apolipoprotein A1 (Apo A1) among DM types. Patients with DM1 (1.73±0.33) and LADA (1.66±0.38) had significantly higher values of HDL compared to DM2 (1.33±0.31). IL-6 was statistically increased in DM2 compared to DM1; Apo A1 was statistically increased in LADA (1.7±0.36) compared to DM2 (1.4±0.22), whereas HCY was decreased (LADA: 10.9±2.74 vs. DM2 18.2±9.44). APN was decreased in DM2 compared to the control group. Logistic regression for DM2 pointed to APN (OR=0.826; p=0.02), HCY (OR=1.202; p=0.08) and HDL (OR=0.142; p=0.08) as statistically significant predictors, whereas uric acid (OR=0.991; p=0.08) was a predictor of LADA. After stepwise procedure the best model for APN included HDL (R2=0.46), for HCY glomerular filtration (parR2=0.26) and Apo A1 (parR2=0.08), and for Apo A1 HDL (parR2=0.79) and fasting glucose (parR2=0.03). 60% of DM2 patients, but 10.5% of LADA were in the 4th LAP quartile. Patients in the 4th quartile had significantly lower values of APN and Apo A1 compared to 1th and 2nd quartiles; HCY was increased in 4th compared to the 1th quartile. Significantly increased HDL and Apo A1 and decreased HCY in LADA compared to DM2 uncover LADA prior to determination of antibodies. Only 10.5% of LADA patients in the 4th quartile pointed to a lower cardiovascular risk than in DM2. Disclosure S. Ljubic: None. A. Jazbec: None. I. Antal: None. I. Cudina: None. M. Tomic: None. M. Vucic Lovrencic: None.

Proinflammatory and anti-inflammatory cytokine profiles in psoriasis: use as laboratory biomarkers and disease predictors

The objectives of this study were to delineate the pro and anti-inflammatory cytokine profiles of psoriasis and cytokine profile models that externally validate the diagnosis. This study recruited 70 patients with psoriasis and 76 healthy controls. Cytokine profiles were evaluated, including pro-inflammatory M1 (IL-1 + IL-6 + TNF-α), Th1 (IL-2 + IL-12 + IFN-γ), Th17 (IL-6 + IL-17), and immune-inflammatory response system (IRS = M1 + Th1 + Th17) profiles. Moreover, the anti-inflammatory potential included Th2 (IL-4), Th2 + T regulatory (Th2 + Treg, namely IL-4 + IL-10 + TGF-β), anti-inflammatory (Th2 + Treg + adiponectin), and the pro-inflammatory/anti-inflammatory index. There was a highly significant association between psoriasis and cytokine levels with an effect size of 0.829 and a particularly strong impact on IL-2 (0.463), IL-12 (0.451), IL-10 (0.532) and adiponectin (0.401). TGF-β and adiponectin were significantly lower while all other cytokines (except IFN-γ) were significantly higher in psoriasis than in controls. In addition, M1, Th1, Th17, Th2 + Treg, and IRS/Anti-inflammatory index were significantly higher in psoriasis patients than in controls. The IRS index, Th2 + Treg, and adiponectin predicted psoriasis with 97.1% sensitivity and 94% specificity. In conclusion, psoriasis is characterized by increased M1, Th1, Th2 and Th17 profiles together with lowered TGF-β and adiponectin. In addition, we propose a model based on a higher IRS and Th2 + Treg index coupled with lower adiponectin values, which may be used to externally validate the diagnosis of psoriasis. The most important single biomarker of psoriasis is adiponectin. Because the latter may play a role in the modulation of the chronic inflammatory response in psoriasis, adiponectin could be a new drug target to treat psoriasis.

Psoriasis in obesity: comparison of serum levels of leptin and adiponectin in obese subjects - cases and controls

Background:Psoriasis and obesity are somewhat related to a low-grade systemic inflammatory response.Objectives:To determine leptin and adiponectin levels in psoriasis patients compared to control patients matched for weight.Methods:A case-control study was performed, evaluating 113 psoriasis patients and 41 controls with other dermatologic diseases.Results:The prevalence of obesity was 33% in cases and 21.9% in controls. All evaluated comorbidities were more prevalent among cases. When stratified by weight, the comorbidities were more frequent in overweight patients. We found no correlation between being overweight (p=0.25), leptin (p=0.18) or adiponectin (p=0.762) levels and psoriasis severity. When overweight cases and controls were compared, we found differences in the adiponectin values (p= 0.04). The overweight cases had lower adiponectin levels than the overweight controls. We found no differences in the leptin dosage between cases and controls. The overweight cases had higher leptin values than the normal weight cases (p<0.001).Study limitations:Several patients used systemic anti-inflammatory medication.Conclusions:The prevalence of obesity among psoriasis cases (33%) was higher than in the general population (17.4%). We did not find any correlation between severity of psoriasis and inflammatory cytokines and the condition of being overweight. The overweight cases had lower values of adiponectin than the overweight controls. It seems, therefore, that there is a relationship between adiponectin and psoriasis, but this relationship depends on the presence of obesity.

Tumor necrosis factor- α, adiponectin and their ratio in gestational diabetes mellitus.

Background:It has been suggested that inflammation might be implicated in the gestational diabetes mellitus (GDM) complications, including insulin resistance. The aims of the current study were to explore maternal circulating values of TNF-α, adiponectin and the adiponectin/TNF-α ratio in women with GDM compared with normal pregnancy and their relationships with metabolic syndrome biomarkers.Methods:Forty women with GDM and 40 normal pregnant women were included in the study. Commercially available enzyme-linked immunosorbent assay methods were used to measure serum levels of TNF-α and total adiponectin.Results:Women with GDM had higher values of TNF-α (225.08±27.35 vs 115.68±12.64 pg/ml, p<0.001) and lower values of adiponectin (4.50±0.38 vs 6.37±0.59 µg/ml, p=0.003) and the adiponectin/TNF-α ratio (4.31±0.05 vs 4.80±0.07, P<0.001) than normal pregnant women. The adiponectin/TNF-α ratio showed negative correlations with insulin resistance (r=-0.68, p<0.001) and triglyceride (r=-0.39, p=0.014) and a positive correlation with insulin sensitivity (r=0.69, p<0.001). Multiple linear regression analysis showed that values of the adiponectin /TNF-α ratio were independently associated with insulin resistance. Binary logistic regression analysis showed that GDM was negatively associated with adiponectin /TNF-α ratio.Conclusions:In summary, the adiponectin/TNF-α ratio decreased significantly in GDM compared with normal pregnancy. The ratio might be an informative biomarker for assessment of pregnant women at high risk of insulin resistance and dyslipidemia and for diagnosis and therapeutic monitoring aims in GDM.

Overall prevalence of feline overweight/obesity in Japan as determined froma cross-sectional sample pool of healthy veterinary clinic-visiting cats in Japan

Many veterinarians feel that feline obesity is increasing in prevalence within Japan, but are unsure as to what real rate of obesity prevalence exists currently. The objectives of this study are twofold. First, we sought to determine the ratio of overweight/obese cats, as determined via body condition score (BCS), based on a cross-sectional pool of healthy cats. Second, using a uniform method of biochemical measurement for cat plasma collected all over Japan, we sought to construct cross-sectional working reference ranges of plasma metabolites using age, BCS, and sex as classifying factors. Overall, the rate of overweight and obese cats (BCS of >3) was 56%, whereas obese cats (BCS >4) constituted 42% of our pool. Aging leads to an increased risk of developing lipid metabolism and kidney issues. Increases in BCS and age both carry increased risk of insulin resistance development. Moreover, increases in BCS bring about a higher risk of developing lipid metabolism problems, which may lead to the development of high cholesterol and triglyceride lipidemia, accompanied by higher levels of free fatty acids. Males appear to have a higher risk than females of developing higher BCS and body weight values, in addition to higher insulin and lower adiponectin values.

Circulating Adipokine Levels in Non-diabetic Subjects with High Normal Blood Pressure.

This study aimed to evaluate the levels of the adipokines, resistin and adiponectin in normotensive and high normal blood pressure patients. Circulating levels of the adipokines, resistin and adiponectin were measured by enzyme-linked immunosorbent assay (ELISA; R'D Systems, Minneapolis) in 20 high normal blood pressure patients and in 20 age-matched normotensive non-diabetic subjects. Statistical analysis was performed with analysis of variance (ANOVA). The control group showed non-significantly decreased levels of resistin when compared with patients with high normal blood pressure [systolic 130-139 mmHg; diastolic 85-89 mmHg] (12.25 vs 14.38 pg/mL, p = 0.40). There were significantly higher levels of adiponectin in the control group when compared with high normal blood pressure patients (11.3 vs 7.51 μg/mL, p = 0.028). High normal blood pressure patients have increased levels of resistin and lower values of adiponectin when compared with age-matched non-diabetic normotensive subjects. This may explain why those patients showed more progression to hypertension, atherosclerosis and cardiovascular risk than normotensive subjects.

Serum adipokine levels and their relationship with fatty acids in patients with chronic periodontitis.

Adipokines are present in inflammatory processes and may be directly related to periodontal disease. Moreover, their activities may be regulated by fatty acids. The goal of this study was to quantify the concentrations of the main adipokines, leptin, adiponectin and resistin, and the docosahexaenoic (DHA), docosapentaenoic (DPA), eicosapentaenoic (EPA) and arachidonic (AA) fatty acids, in patients with generalized chronic periodontitis. As a secondary objective, the ratios of these substances in the blood of these patients were evaluated. The study included 15 systemically healthy patients with generalized chronic periodontitis (test group) and 15 patients with gingivitis (control group). Medical and periodontal parameters and blood samples were collected. Serum concentrations of fatty acids were analyzed by gas chromatography and adipokines by multiplex bead immunoassay. There was no significant difference in adipokines between groups. However, there was a tendency for lower values of adiponectin in periodontitis patients. Regarding the fatty acids, they were significantly higher in the test group compared with controls. The res/DHA, res/AA, adipon/DHA, adipon/AA and adipon/DPA ratios were significantly lower in the test group. There was no significant correlation between adipokines and clinical parameters and between adipokines and fatty acids levels. It was concluded that generalized chronic periodontitis patients showed significantly higher levels of fatty acids in comparison to gingivitis; adiponectin revealed a trend to lower values in the periodontitis group, even after Ancova correction. The ratios suggest a minor proportion of adiponectin and resistin in relation to the fatty acids in patients with generalized chronic periodontitis.

Insights into the pathophysiology of catch-up compared with non-catch-up growth in children born small for gestational age: an integrated analysis of metabolic and transcriptomic data

Small for gestational age (SGA) children exhibiting catch-up (CU) growth have a greater risk of cardiometabolic diseases in later life compared with non-catch-up (NCU) SGA children. The aim of this study was to establish differences in metabolism and gene expression profiles between CU and NCU at age 4-9 years. CU children (n=22) had greater height, weight and body mass index standard deviation scores along with insulin-like growth factor-I (IGF-I) and fasting glucose levels but lower adiponectin values than NCU children (n=11; all P<0.05). Metabolic profiling demonstrated a fourfold decrease of urine myo-inositol in CU compared with NCU (P<0.05). There were 1558 genes differentially expressed in peripheral blood mononuclear cells between the groups (P<0.05). Integrated analysis of data identified myo-inositol related to gene clusters associated with an increase in insulin, growth factor and IGF-I signalling in CU children (P<0.05). Metabolic and transcriptomic profiles in CU SGA children showed changes that may relate to cardiometabolic risk.

Adipocytokines during pregnancy and postpartum in women with gestational diabetes and healthy controls.

This study aims to explore the changes in maternal serum adipocytokines during pregnancy and post partum in normal and complicated with gestational diabetes (GDM) pregnancies and to investigate the relationship between serum adipocytokines and some of major metabolic parameters. 236 pregnant women (127 with GDM and 109 control group) and 50 postpartum women (30 with GDM during pregnancy and 20 controls). Using ELISA and EIA kits, serum levels of adipocytokines were tested during pregnancy and post partum. Maternal adipocytokines levels were correlated with some metabolic parameters. Women with GDM had lower values of adiponectin and higher values of leptin during pregnancy (p<0.001; 0.0001) and post partum (p<0.002; 0.0001). Serum apelin was significantly lower in GDM group (p<0.009). However, we did not find significance for resistin (p<0.317) and apelin (p<0.218). Positive correlation for leptin and negative for adiponectin was found for pre-pregnancy and pregnancy body mass index, glycated hemoglobin and homeostasis model assessment of insulin resistance index. Using cut point of 8.2 μg/ml for adiponectin and 28.7 ng/ml for leptin could exclude GDM with a sensitivity of 83.6%/81.2% and specificity of 56.6%/64.2% (area under the curve 0.702 and 0.827). There are constant differences in adiponectin and leptin levels between GDM and control group during pregnancy and post partum. Apelin was decreased in our GDM group and no differences were found for resistin and visfatin. Further studies are required to verify the mechanism of this alteration and whether the adipocytokines can be predictors for GDM at an early stage of pregnancy.

Association of serum adiponectin and insulin-like growth factor I levels with parameters of cardiac remodeling in severely obese patients.

Obesity is associated with various changes in cardiac geometry and this process involves both hemodynamic and non-hemodynamic factors, among which adipocitokines and growth factors may play an important role. The aim of this study was to identify the extent and pattern of cardiac remodeling in a group of severely obese patients and analyze the relationship between adiponectin, IGFI and cardiac parameters reflecting obesity-associated structural changes. Our study included 344 patients (104 men) with severe obesity [mean body mass index (BMI)= 45.7 ± 8.5 kg/m(2)], extensively evaluated clinically and biologically (complete metabolic tests, serum adiponectin, and IGF-I measurements). Left ventricular (LV) mass index (LVMI), left atrium (LA) size, and LV geometry were determined by means of cardiac ultrasound. The most prevalent pattern of LV geometry was eccentric hypertrophy (28.7% of patients). In a gender-, age-, BMI-, diabetes- and hypertension-adjusted general linear model, patients with concentric or eccentric hypertrophy had significantly lower values of adiponectin than those with normal geometry (6.75 ± 0.41, 6.96 ± 0.53, vs 9.04 ± 0.42 mg/l, p<0.05). In multivariate analysis, independent determinants for LVMI were BMI (β=0.364, p<0.001), systolic blood pressure (BP) (β=0.187, p=0.004), age (β=0.246, p<0.001), adiponectin (β=-0.151, p=0.012), and IGF-I z-score (β=0.134, p=0.025) while factors independently related to LA size were systolic BP (β=0.218, p<0.001), BMI (β=0.194, p<0.001), age (β=0.273, p<0.001), gender (β=-0.195, p<0.001), and adiponectin (β=-0.180, p=0.005). In patients with severe obesity, IGF-I z score and adiponectin correlate with parameters of cardiac remodeling independently of anthropometric, hemodynamic or metabolic factors.

Adipocytokine Levels in Obese and Non-obese Subjects: an Observational Study

We evaluated the levels of some inflammatory adipocytokines in 363 obese and 365 non-obese subjects. We measured: body mass index (BMI), waist circumference (WC), fasting plasma glucose, fasting plasma insulin (FPI), homeostasis model assessment (HOMA) index, blood pressure, lipid profile, retinol binding protein-4 (RBP-4), vaspin, omentin-1, leptin, interleukin-6 (IL-6), visfatin, resistin, adiponectin (ADN), adipsin, tumor necrosis factor-α (TNF-α), and high sensitivity C-reactive protein (Hs-CRP). We observed higher BMI, WC, FPI, HOMA index, TC, LDL-C, RBP-4, leptin, IL-6, adipsin, Hs-CRP, vaspin, resistin and TNF-α levels, and lower visfatin, and ADN levels in obese compared to non-obese subjects. Higher WC correlated with lower ADN and visfatin levels, and higher vaspin levels. Higher HOMA index correlated with higher resistin, adipsin, RBP-4, and leptin concentrations, while higher leptin levels correlated with higher TNF-α, Hs-CRP, and IL-6 concentration, and lower ADN values. We confirmed obese subjects' predisposition to develop dysmetabolic disease and hormonal dysfunctions.

Prevalence of Inflammatory Markers (High-Sensitivity C-Reactive Protein, Nuclear Factor-κB, and Adiponectin) in Indian Patients with Type 2 Diabetes Mellitus with and without Macrovascular Complications

Atherosclerosis is more prevalent in subjects with diabetes mellitus. Recent evidence suggests that diabetic atherosclerosis is not simply a disease of hyperlipidemia, but is also an inflammatory disorder. Our aim was to study the prevalence of inflammatory markers such as high-sensitivity C-reactive protein (hsCRP), adiponectin, and nuclear factor-κB (NF-κB) expression, in peripheral blood mononuclear cells in Indian patients with type 2 diabetes mellitus (T2DM) with and without macrovascular disease (MVD). A total of 29 consecutive cases of T2DM with proven MVD (group A), 28 matched cases without MVD (group B), and 14 healthy controls (group C) were evaluated for the clinical parameters fasting blood glucose (FBG), 2-h postprandial blood glucose (PPBG), glycosylated hemoglobin (HbA1c), lipid profile, and the above-mentioned inflammatory markers. Diabetic subjects with T2DM had higher hsCRP and NF-κB expression and lower values of adiponectin compared to healthy controls. Group A had significantly higher serum hsCRP than group B (P=0.0001) despite comparable values of BMI, FBG, 2-h PPBG, HbA1c, and lipid parameters. Group A had significantly higher serum hsCRP and NF-κB expression and significantly lower levels of adiponectin than group C (P=0.0001, 0.007, and 0.02, respectively). In Group A, serum adiponectin negatively correlated with NF-κB expression. In Group B, adiponectin values correlated negatively with both FBG and 2-h PPBG. Indian subjects with T2DM with or without MVD had higher hsCRP and lower adiponectin values as compared to healthy controls, whereas hsCRP was significantly higher in those with MVD, suggesting that our patients with T2DM were in a proinflammatory state.

RELATIONSHIP BETWEEN GLUCOSE METABOLISM AND MICROALBUMINURIA IN WOMEN WITH PRIOR GESTATIONAL DIABETES: PP.17.158

Aims: Relationship between glucose abnormalities and microalbuminuria in women with pGDM.W. Methods: We prospectively studied 215 women with pGDM. According to OGTT, we divided into two groups: pGDM with normal glucose tolerance post-partum (NG) (66,8%) and pGDM with abnormal glucose tolerance post-partum (AG) (33,2%). Insulin sensitivity was derived using HOMA. Metabolic syndrome (MS) was defined by ATP-III We collected obstetric history, personal history of pGDM and personal and family history of cardiovascular risk factors. Microalbuminuria and glomerular filtration by MDRD were measured. Results: Mean age was 33,45 ± 4,5 yrs.; 26,25% smoking, 15,6% history of dyslipemia, 30% had history of previous abortions. 62,34% of women had first-degree relatives with type 2 DM and 59,25% had family history of hypertension The prevalence of MS was higher (32,3%) in AG group than in NG (14,7 %); p < 0.005. In addition, AG group had higher values of BMI and WC vs. NG group (28,86 ± 4,5 vs 22,70 ± 3,1 Kg/m2; p < 0.005 and 93,76 ± 6,1 vs 80,34 ± 4,6; p < 0.05, respectively). Fasting glucose and 2h-glucose levels were higher in AG group than NG (98,85 ± 7,7 vs 80,2 ± 5,6 mg/dl, p < 0.005 and 166,57 ± 23 vs 119,4 ± 20 mg/dl). Fasting insulin and HOMA values were significantly higher in AG than NG; p < 0.005. Microalbuminuria levels in AG group were greater (29.4 ± 13 mg/24 h) vs NT (11.67 ± 4,7 mg/24 h; p < 0.05). No differences in renal function. In addition, AG group presented a higher prevalence of family history of type 2 DM (68,7% vs 48%, p < 0.01). Conclusion: Women with pGDM have a high prevalence of abnormal glucose tolerance and MS and lower values of adiponectin, particularly those with AG (and with higher levels of microalbuminuria). Thus women with pGDM and family history of type 2 DM may be especially suitable interventions aimed at preventing or reducing type 2 DM and probably cardiovascular events.

Abstract 3109: Exaggerated Blood Pressure Response During Treadmill Test is Accompanied by a State of Pronounced Albuminuria, Hypoadiponectinemia and Increased Asymmetric Dimethylarginine Levels in Essential Hypertension

Introduction: A hypertensive response to exercise (HRE) is associated with high cardiovascular risk, whereas the data regarding its relation to markers of atherosclerosis progression are currently scarce. Hypothesis: Urinary albumin excretion, expressed as the albumin to creatinine ratio (ACR), asymmetric dimethylarginine (ADMA) levels, and adiponectin may be correlated with HRE in essential hypertensives. Methods: Our population of 109 newly diagnosed untreated non-diabetics with stage I to II essential hypertension [76 men, mean age =52 years, office blood pressure (BP) = 146/94 mmHg] with a negative treadmill exercise test (Bruce protocol) were divided into those with HRE (n=34) (peak exercise systolic BP ≥ 210mmHg in men and ≥190 mmHg in women) and to those without HRE (n=75). In all subjects ACR values were determined as the mean of two non-consecutive morning spot urine samples and venous blood samples were drawn for estimation of adiponectin and ADMA concentrations. Results: Patients with HRE compared to those without HRE were older (55 ± 9 vs 51 ± 9 years, p&lt;0.05), had greater 24-h systolic BP (141 ± 13 vs 132 ± 12 mmHg, p&lt;0.05), while did not differ regarding metabolic profile and left ventricular mass index (p = NS). Patients with HRE compared to those without HRE exhibited greater levels of ADMA (0.62 ± 0.05 vs 0.54 ± 0.04 μ mol/l, p&lt;0.0001) and ACR (61.4 ± 12 vs 15.2 ± 2.2 mg/g, p&lt;0.0001), whereas had lower adiponectin values (6.1 ± 1.4 vs 9.3 ± 2.1 μg/ml, p&lt;0.0001), independently of confounders. In the total population, peak exercise systolic BP was related to 24-h systolic BP (r=0.239, p&lt;0.05), ACR (r=0.432, p&lt;0.0001), ADMA (r=0.260, p=0.007), and negatively associated with adiponectin (r = −0.216, p&lt;0.05). Multiple regression analysis revealed that 24-h systolic BP (b=0.232, p=0.023), male sex (b=0.240, p=0.029) and ACR (b=0.450, p&lt;0.0001) were independent predictors of peak exercise systolic BP. Conclusions: In essential hypertension, a HRE is associated with hypoadiponectinemia, augmented ADMA and ACR values, reflecting activation of diverse pro-atherosclerotic pathways. These findings suggest that treadmill exercise testing could be an additional tool to identify hypertensive patients with pronounced cardiorenal vascular dysfunction.

Adiponectin concentrations as a criterion of metabolic control in persons with type 2 diabetes mellitus?

Adiponectin (ADP) is an adipocytokin with many antiatherogenic properties; its decreased level is associated with numerous atherogenic diseases and syndromes (e.g. diabetes mellitus (DM), dyslipidemia, endothelial dysfunction, hypertension, and obesity). Decreased ADP values in blood may be an independent risk factor of atherosclerotic (ATS) complications. 1) Do persons with type 2 diabetes have lower ADP values than individuals without DM but with a high risk of ATS complications? 2) Do ADP values differ between persons with well controlled and persons with uncontrolled type 2 diabetes? We examined 109 patients of the Metabolic Center of Hospital Sternberk. Out of them, 58 had type 2 diabetes, others were individuals with variously expressed risk factors of early atherosclerosis (obesity, hypertension, age, family history, smoking, dyslipidemia, etc.). In all persons under this study the following parameters were determined in peripheral venous blood: adiponectin, resistin, leptin, ObRe, cholesterol, HDL-cholesterol, triacylglycerols, glucose, HbA1c, creatinine, urea, ALT, AST, CRP, homocysteine, thrombocyte aggregation after CPG induction. The whole group was divided according to the presence of type 2DM into two subgroups; persons with diabetes were divided into the well controlled and uncontrolled subgroups. All data obtained were processed statistically using the software SPSS for Windows and Medcalc. The adiponectin/BMI index correlated negatively with HbA1c value (correlation coefficient -0.37, p = 0.00053), triacylglycerols (-0.4, p = 0.000001), P-glucose (-0.3, p = 0.0017), uricemia (-0.35, p = 0.0007) and positively with HDL-cholesterol value (0.6, p=0.00001). Women had higher adiponectin values than men. Persons with hypertension and with diabetes mellitus, individuals with atherogenic lipotype or persons with inflammation signs had lower values than individuals without these diseases and syndromes. Persons with wellcontrolled diabetes mellitus had higher values than persons with uncontrolled diabetes (medians of the adiponectin/BMI index 9.7 vs. 6.7, p < 0.01). Persons with type 2 diabetes mellitus have lower ADP values than persons with a high ATS risk without diabetes mellitus. Persons with wellcontrolled diabetes mellitus (DM) and with satisfactory compensation have significantly higher ADP levels (independently of other metabolic parameters of DM control). ADP may be a new marker of metabolic control in persons with a high risk of atherosclerotic complications.