Rising Adiponectin Levels Lower Diabetes Risk in Elderly
Lower risk as total, high-molecular-weight adiponectin increase up to defined thresholds
THURSDAY, Dec. 15 (HealthDay News) -- In older adults, increasing concentrations of total and high-molecular-weight (HMW) adiponectin up to 20 and 10 mg/L, respectively, are inversely associated with incident diabetes, according to a study published online Dec. 6 in Diabetes Care.
Jorge R. Kizer, M.D., from Weill Cornell Medical College in New York City, and colleagues examined the association of total adiponectin, HMW adiponectin, and the HMW-to-total adiponectin ratio with diabetes among 3,802 older adults. Incident diabetes was identified in 309 cases.
The investigators found that there was a strong correlation between total and HMW adiponectin (r = 0.94). The associations between total and HMW adiponectin and new-onset diabetes were non-linear on cubic splines analysis. After adjusting for confounders, total and HMW adiponectin expressed similar inverse correlations with diabetes up to concentrations of 20 and 10 mg/L, respectively (hazard ratio per standard deviation, 0.49 and 0.42, respectively); the associations plateaued above those levels. The associations remained, even after adjusting for potential mediators, including blood pressure, lipids, C-reactive protein, and the homeostasis model assessment of insulin resistance. In the lower range, the homeostasis model assessment of insulin resistance showed evidence of an adiponectin interaction, with insulin-sensitive participants showing stronger inverse associations than insulin resistant participants. A linear adjusted association was identified between HMW-to-total adiponectin ratio and diabetes, which did not persist after inclusion of mediating variables.
"In this older cohort, increasing concentrations of total and HMW adiponectin were associated with comparably lower risks of diabetes, but these associations leveled off with further increases above concentrations of 20 and 10 mg/L, respectively," the authors write.