The Relationship Of Plasma Adiponectin And Diabetic Angiopathy In Type 2 Diabetes Mellitus Patients

Objective: This study was aimed to observe the changes of plasma adiponectin in type 2 diabetes mellitus patients with different vascular complications and to explore the role of plasma adiponectin in pathogenesis of type 2 diabetes and its vascular complications.Methods:1 Subjects: Eighty type 2 diabetes mellitus patients, aged between 45 and 75, with the diabetes'history of less than 5 years , were chosen in this study. According to different vascular complications, the subjects were divided into diabetes macroangiopathy group (MM), diabetes microangiopathy group (MV), simple diabetes group (SD). And the diabetes microangiopathy group was subdivided further into diabetic retinopathy group(MVE),diabetic nephropathy group (MVN),diabetic retinopathy and nephropathy group (MVEN).2 Methods: Height, weight, waistline and hipline of all the subjects were measured. Blood and urine samples of subjects were examined for blood lipid(TC,TG,LDL-C,VLDL-C,HDL-C,APOA,APOB,APOa), HbA1c, 24 hours urinary albumin excretory rate, plasma adiponectin, fasting blood glucose, 30 minutes blood glucose, insulin and C-peptide after taking glucose. Moreover, Body mass index(BMI), waist hip ratio(WHR), HOMA-IR, HOMA-βand△I 30/△G30 were calculated. Those indexes were compared among various test groups and the correlation between plasma adiponectin and those indexes was further evaluated in the study.3 Statistical analysis: Descriptive statistics were presented as mean±standard deviation (SD) , and were analyzed by SPSS 11.5 statistical process. Student's t-test,analysis of variance (ANOVA),univariate and stepwise mulitiple linear regression analysis were used. A value of P<0.05 was considered to be statistically significant .Results:1 The plasma adiponectin level in MM group was lower than in MV group snd in SD group, which had statistical significance(with MV P<0.05 and with SD P<0.01); the plasma adiponectin level in MM group was lower than SD group, which had statistical significance too(P<0.05).2 There was no statistical significance among data of MVE group,MVN group and MVEN group, which all belong to diabeties microangiopathy group.3 Pearson correlation and multinomial linear regression analysis3.1 In all subjects the plasma adiponectin correlated negtively with HbA1c(r=-0.278,P<0.05),BMI(r=-0.406,P<0.01),WHR ( r=-0.475,P<0.01 ),HOMA-IR(r=-0.260,P<0.01). In stepwise multinomial linear regression analysis BMI and WHR could enter into the equation: adiponectine=1.524-0.377BMI-0.376WHR,R is -0.377(P<0.01) and -0.376(P<0.01), if adiponectin served as dependent variable.3.2 In MM group the plasma adiponectin correlated negtively with HbA1c(r=-0.522,P<0.01),BMI(r=-0.455,P<0.05),WHR(r=-0.468,P<0.05),HOMA-IR(r=-0.427,P<0.05),and correlated positively with HDL-C ( r=0.484,P<0.05 ),△I 30/△G 30(r=0.430,P<0.05). In stepwise mulitiple linear regression analysis HbA1c and HOMA-IR could enter into the equation: adiponectin=1.059-0.469HbA1c-0.358 HOMA-IR,R is -0.469(P<0.05)and -0.358(P<0.05), if adiponectin served as dependent variable.3.3 In MV group the plasma adiponectin correlated negtively with BMI (r=-0.348,P<0.05), WHR (r=-0.451,P<0.01). In stepwise mulitiple linear regression analysis WHR could enter into the equation: adiponectin=-0.359-0.451WHR,R is -0.451(P<0.01),if adiponectin served as dependent variable.3.4 In SD group the plasma adiponectin correlated negtively with BMI (r=-0.462,P<0.05), WHR (r=-0.573,P<0.01) , HbA1c (r=-0.455,P<0.05), HOMA-IR (r=-0.445,P<0.05), and correlated positively with HDLC (r=0.587,P<0.01) and HOMA-β(r=0.576,P<0.01). In stepwise mulitiple linear regression analysis HDL-C, HOMA-βcould enter into the equation:adiponectin=-0.874+0.451HDL-C +0.434 HOMA-β,R is 0.451(P<0.05)and 0.434(P<0.05), if adiponectin served as dependent variable. Conclusion:1 The plasma adiponectin level decreases when type 2 diabetes is accompanied with vascular complications. Lower blood plasma adiponectin level predicts a higher possibility of macrovascular complications.2 The plasma adiponectin level has no obvious difference to generate different type microvascular complications in diabetic microangiopathy group.3 Blood plasma adiponectin level correlates negtively with BMI, WHR and HbA1c, which indicates that obesity and hyperglycemia are influencial factors of plasma adiponectin.4 Blood plasma adiponectin level correlates positively with HDL-C which is a protective factor and has desirable efficacy to prevent and cure diabetic vascular complications.