Abstract 3906: Adiponectin and Risk of Type 2 Diabetes Mellitus in Apparently Healthy Middle-Aged Men From General Population
Background: Adiponectin, an obesity related hormone produced by adipocytes is linked to insulin resistance and has anti-inflammatory properties. Thus, it has been postulated that high serum concentrations may be protective against type 2 diabetes mellitus (T2DM).
Methods: Serum concentrations of adiponectin were determined by ELISA (R&D, Wiesbaden, Germany) in 887 apparently healthy men aged 45–64 years, sampled from the population-based MONICA/KORA Augsburg survey conducted in 1984/85 and followed up until 2002. T2DM was assessed by questionnaire and validated by review of medical records.
Results: During the study 115 of 887 men had a newly diagnosed T2DM. Median baseline levels of adiponectin were lower in subjects with incident T2DM compared to event-free subjects (5.0 μg/ml versus 6.4 μg/ml, p<0.001). In a Cox model, adjusted for age, subjects in the top tertile of adiponectin concentrations compared to the bottom tertile had a significantly decreased risk for a new-onset T2DM (HR 0.44; 95% CI, 0.28 – 0.70, p for trend 0.0007). After additional controlling for BMI, smoking, physical activity, alcohol consumption, actual hypertension, history of myocardial infarction, and total cholesterol, the RR slightly increased but still remained statistically significant (HR 0.55; 95% CI, 0.34 – 0.88, p for trend 0.015). Only after further inclusion of HDL-cholesterol in the model, the estimate for the predictive value of low adiponectin formally lost its statistical significance (HR 0.81, 95% CI 0.50–1.33; p for trend 0.40). In joint analysis, men with low adiponectin and low HDL-C values showed a 2.6 times (95% CI 1.67–4.15) increased incidence of T2DM after multivariable adjustment in comparison to men with high HDL-C and high adiponectin.
Conclusions: Lower serum concentrations of adiponectin are associated with increased risk of future T2DM in apparently healthy middle-aged men. For patients with low HDL-C values, additional measurement of adiponectin may be helpful to identify individuals at very high risk for T2DM.