Increasing plasma adiponectin is associated with reduced risk of type 2 diabetes and subsequently reduced cardiovascular events

Abstract

Purpose: Adiponectin is an insulin-sensitizing hormone produced from adipose tissue, which is reduced in a number of metabolic disorders, including diabetes mellitus (T2DM), adipositas and metabolic syndrome. It is also believed to exert anti-inflammatory and anti-atherogenic effects on cardiovascular (CV) tissue possibly acting against arteriosclerosis. Accordingly we investigated whether plasma adiponectin was associated with risk of developing T2DM and subsequently CV-events. Methods: We prospectively followed 5.359 randomly selected healthy men and women from the community without diabetes and CV-disease. Plasma adiponectin was measured at the beginning of the study. Median follow-up time was 7.8 years (IQR: 7.3-8.3 years). During follow-up 135 participants developed T2DM requiring medical therapy. Following their diagnosis of T2DM 30 of the 135 participants had a CV-event (myocardial infarction, ischemic stroke or CV-death). Results: Participants with increasing adiponectin had reduced risk of developing T2DM (p<0.001). After adjustment for confounding risk factors (including age, gender, BMI, glucose, HbA1c, blood pressure, lipids, current smoking, alcohol consumption, physical activity, hsCRP, eGFR and pro-BNP) by Cox-regression analysis, adiponectin remained an independent predictor of T2DM: hazard ratio for each doubling of adiponectin: 0.56 (95% CI 0.41-0.75; p<0.001). After development of T2DM, risk of CV-event increased threefold, however, increasing adiponectin (adjusted for confounding risk factors) was associated with reduced incidence of CV-events, HR: 0.29 (95% CI 0.13-0.64; p=0.002) for each doubling in plasma adiponectin. (figur presented) Conclusions: In conclusion, increasing plasma adiponectin is associated with reduced risk of T2DM and subsequently reduced cardiovascular events.