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Adipokines and Incident Type 2 Diabetes in an Aboriginal Canadian Population: The Sandy Lake Health and Diabetes Project

¹Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
²Center for Studies in Family Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
³Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
⁴Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
⁵Sandy Lake Health and Diabetes Project, Sandy Lake, Ontario, Canada
⁶Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore,
⁷Robarts Research Institute and University of Western Ontario, London, Ontario, Canada
⁸Division of Endocrinology, University of Toronto, Toronto, Ontario, Canada
⁹Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada
¹⁰Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Canada

anthony.hanley{at}utoronto.ca

ABSTRACT

Objective: The aim of this study was to investigate associations of adiponectin, leptin, C-reactive protein (CRP), interleukin 6 (IL-6), and serum amyloid A (SAA), individually or in combinations, with risk of incident type 2 diabetes in an Aboriginal Canadian population.

Research Design and Methods: Of the 606 Sandy Lake Health and Diabetes Project cohort subjects who were free of diabetes at baseline, 540 (89.1%) participated in 10-year follow-up assessments. Concentrations of fasting adiponectin, leptin, CRP, IL-6, SAA and covariates were measured at baseline. Fasting glucose and a 75-g oral glucose tolerance test were obtained at baseline and follow-up to determine incident type 2 diabetes, defined as clinically diagnosed type 2 diabetes or as fasting plasma glucose 7.0 mmol/l or 2-h postload plasma glucose 11.1 mmol/l at follow-up.

Results: Low adiponectin, high leptin and the low adiponectin-to-leptin ratio at baseline were associated with increased risk of incident type 2 diabetes after adjustment for age, sex, triglyceride, HDL cholesterol, hypertension, and impaired glucose tolerance (odds ratio [OR] 0.63 [95%CI 0.48–,0.83], 1.50 [1.02–,2.21], and 0.54 [0.37–,0.77]), respectively. When the models were additionally adjusted for waist circumference or BMI, however, only low adiponectin remained significantly associated with increased incident diabetes (OR 0.68 [0.51–,0.90]). Combinations of leptin, CRP, IL-6, and/or SAA with adiponectin, assessed using either the ratio or joint effects, did not improve diabetes prediction.

Conclusions: Low baseline adiponectin is associated with increased risk of incident type 2 diabetes independent of leptin, CRP, IL-6, SAA, and metabolic syndrome variables including obesity.

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