Adiponectin and All-Cause Mortality in Elderly People With Type 2 Diabetes
- Jessica R. Singer, MD1,
- Walter Palmas, MD, MS1,
- Jeanne Teresi, PHD2,3,
- Ruth Weinstock, MD, PHD4,5,
- Steven Shea, MD, MS1,6 and
- José A. Luchsinger, MD, MPH1,6⇓
- 1Department of Medicine, Division of General Medicine, Columbia University, New York, New York
- 2Research Division, Hebrew Home at Riverdale, Bronx, New York
- 3Stroud Center, Columbia University, and New York State Psychiatric Institute, New York, New York
- 4Joslin Diabetes Center and Division of Endocrinology, Diabetes and Metabolism, SUNY Upstate Medical University, Syracuse, New York
- 5Department of Veterans Affairs, VA Medical Center, Syracuse, New York
- 6Department of Epidemiology, Joseph Mailman School of Public Health, Columbia University, New York, New York
- Corresponding author: José A. Luchsinger, jal94{at}columbia.edu.
Abstract
OBJECTIVE To assess the association between serum adiponectin level and all-cause mortality in people with type 2 diabetes. Because of the insulin-sensitizing, anti-inflammatory and antiatherogenic effects of adiponectin, we hypothesized that higher adiponectin level would be associated with lower all-cause mortality.
RESEARCH DESIGN AND METHODS A total of 609 men and women aged 72 ± 6.3 years with type 2 diabetes and information on total and high molecular weight adiponectin were followed for a median of 5 years. The longitudinal association between adiponectin and all-cause mortality was analyzed with Cox proportional hazards models with time from adiponectin measurement to death as the time-to-event variable. Analyses were adjusted for demographic variables and significant diabetes parameters, significant cardiovascular parameters, and significant diabetes medications.
RESULTS Total and high molecular weight adiponectin were highly correlated. The highest adiponectin quartile was strongly associated with higher all-cause mortality compared with the lowest quartile (hazard ratio = 4.0 [95% CI: 1.7–9.2]) in the fully adjusted model. These results did not change in analyses stratified by sex and thiazolidinedione use, after exclusion of people who died within one year of adiponectin measurement, or when change in weight before adiponectin measurement was considered.
CONCLUSION Contrary to our hypothesis, higher adiponectin level was related to higher all-cause mortality. This association was not explained by confounding by other characteristics, including medications or preceding weight loss.
- Received November 15, 2011.
- Accepted April 3, 2012.
- © 2012 by the American Diabetes Association.
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