Associations of Adiponectin Levels With Incident Impaired Glucose Metabolism and Type 2 Diabetes in Older Men and Women

The Hoorn Study

  1. Marieke B. Snijder, PHD12,
  2. Robert J. Heine, MD, PHD2,
  3. Jacob C. Seidell, PHD12,
  4. Lex M. Bouter, PHD2,
  5. Coen D.A. Stehouwer, MD, PHD3,
  6. Giel Nijpels, MD, PHD2,
  7. Tohru Funahashi, PHD4,
  8. Yuji Matsuzawa, MD, PHD4,
  9. Iichiro Shimomura, MD, PHD4 and
  10. Jacqueline M. Dekker, PHD2
  1. 1Institute of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
  2. 2EMGO Institute, VU University Medical Center Amsterdam, Amsterdam, the Netherlands
  3. 3Internal Medicine, Academic Hospital Maastricht, Maastricht, the Netherlands
  4. 4Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Osaka, Japan
  1. Address correspondence and reprint requests to Marieke B. Snijder, PhD, Institute of Health Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, Netherlands. E-mail: marieke.snijder{at}falw.vu.nl

Abstract

OBJECTIVE—Adiponectin is an adipose tissue–derived protein. Low levels are associated with obesity, insulin resistance, and type 2 diabetes. Our objective was to investigate the prospective association between adiponectin levels and the 6.4-year risk of type 2 diabetes and of impaired glucose metabolism (IGM).

RESEARCH DESIGN AND METHODS—The Hoorn Study is a cohort study among Caucasians, aged 50–75 years. BMI, waist-to-hip ratio (WHR), fasting glucose, 2-h glucose, triglycerides, HDL cholesterol, LDL cholesterol, alanine aminotransferase, leptin, and adiponectin were measured at baseline. Lifestyle (alcohol intake, smoking, and physical activity) was assessed by questionnaires. After a mean follow-up of 6.4 years, glucose tolerance was assessed by a 75-g oral glucose tolerance test. Analyses were performed in 1,264 subjects (584 men and 680 women) without type 2 diabetes at baseline. For analyses of incident IGM, 239 subjects with IGM at baseline and/or type 2 diabetes at follow-up were excluded.

RESULTS—Age- and lifestyle-adjusted odds ratios and 95% CIs comparing highest with lowest adiponectin quartile were 0.52 (0.23–1.18) in men and 0.15 (0.06–0.39) in women for type 2 diabetes and 0.90 (0.51–1.61) and 0.28 (0.16–0.48) for IGM, respectively. The risks were only slightly reduced after adjustment for WHR and leptin as markers of (abdominal) adiposity. Adjustment for baseline fasting and postload glucose levels (potential mediators) substantially diminished these inverse associations with type 2 diabetes (0.79 [0.32–1.91] and 0.62 [0.21–1.81]) and with IGM (1.20 [0.61–2.35] and 0.48 [0.26–0.90]), respectively.

CONCLUSIONS—A high adiponectin level was strongly associated with a lower risk of IGM and type 2 diabetes, particularly in women. These results suggest that adiponectin is involved in the pathophysiology linking obesity to type 2 diabetes.

Footnotes

  • A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted August 4, 2006.
    • Received May 10, 2006.
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  1. doi: 10.2337/dc06-0952 Diabetes Care November 2006 vol. 29 no. 11 2498-2503
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