Relationship among the leptin-to-adiponectin ratio, systemic inflammation, and anisocytosis in well. controlled type 2 diabetic patients with atherosclerotic cardiovascular disease

Abstract

BACKGROUND Previous studies have shown that red blood cell distribution width (RDW) is an independent predictor of poor prognosis in type 2 diabetes (T2D) and atherosclerotic cardiovascular disease (ASCVD). The mechanisms underlying increased anisocytosis in patients with T2D and confirmed ASCVD remain poorly understood. AIMS We sought to evaluate the relationship among the leptin-to-adiponectin ratio, systemic low.grade inflammation, and RDW in optimally treated patients with T2D and established ASCVD. METHODS A total of 68 patients, aged 47 to 85 years (mean [SD], 65.3 [6.8] years) and including 21 women (30.9%), were enrolled and grouped according to median RDW into those with RDW <13.5% (n = 33) and those with RDW .13.5% (n = 35). RESULTS Patients with RDW .13.5% had a significantly higher median (interquartile range [IQR]) serum leptin-to-adiponectin ratio (1.7 [0.49.2.3] ng/ g vs 0.66 [0.31.1.25] ng/ g; P = 0.04) and median (IQR) tumor necrosis factor levels (1.58 [1.42.1.97] pg/ml vs 1.39 [1.18.1.57] pg/ml; P = 0.02). There were no significant differences in the concentrations of other inflammatory markers. The leptin-to-adiponectin ratio (r = 0.25; P = 0.04) and levels of tumor necrosis factor α (r = 0.32; P = 0.01) and soluble intercellular adhesion molecule 1 (r = 0.31; P = 0.01) were positively correlated with RDW, which was confirmed by univariate linear regression analysis. A multivariable regression model, which included demographic, clinical, and laboratory data, showed that white blood cell count (β = 0.25; 95% CI, 0.05.0.45; P = 0.01), soluble intercellular adhesion molecule 1 levels (β = 0.21; 95% CI, 0.02.0.41; P = 0.03), and mean corpuscular hemoglobin concentration (MCHC), (β = .0.48; 95% CI, 0.67 to .0.28; P <0.001) were independent predictors of RDW in our patients.