Presentation on theme: "MODIFIED ADIPOKINE LEVELS IN TYPE 1 DIABETIC PATIENTS: ASSOCIATION WITH CAROTID INTIMA MEDIA THICKNESS Dilek Yazıcı, Dilek Yavuz, Önder Şirikçi, Ahmet."— Presentation transcript:
MODIFIED ADIPOKINE LEVELS IN TYPE 1 DIABETIC PATIENTS: ASSOCIATION WITH CAROTID INTIMA MEDIA THICKNESS Dilek Yazıcı, Dilek Yavuz, Önder Şirikçi, Ahmet Toprak, Özlem Tarçın, Seda Sancak, Oğuzhan Deyneli, Sema Akalın Marmara University Medical School Section of Endocrinology and Metabolism İstanbul
Serum adiponectin levels were shown to be decreased in type 2 diabetes melitus and in conditions associated with insulin resistance and cardiovascular diseases. In contrast, elevated levels have been reported in type 1 diabetic patients. Schalkwikj CG, JECM 2006, 91(1); Frystyk J, Diabetologia 2005, 48(9); Hadjadj S, Diabetologia 2005,48(6); Yaturu S, Cytokine 2006,34; Nakashima, JCEM,2006;,91, Kowalska, Adv Med Sci, 2006, 51,94-7 Adiponectin
Adiponectin is especially increased in type 1 diabetic patients with microvascular complications. Schalkwikj CG, JECM 2006, 91(1); Frystyk J, Diabetologia 2005, 48(9); Hadjadj S, Diabetologia 2005,48(6); On the other hand, there is conflicting data on the association of adiponectin with the presence of macrovascular disease in this population. Costacou,Diabetologia, 2005, 48(1);41-8. Schalkwikj CG, JECM 2006, 91(1); Frystyk J, Diabetologia 2005, 48(9);
Other Adipokines Schaffler, Horm Metab Res, 2004, 36(10);702-7 Roden MI, Int J Obes Relat Metab Disord,2000, 24(8), Leptin and resistin were both found to be decreased in adult patients with type 1 diabetes mellitus. The relationship of leptin and resistin with macrovascular complications is not evident in adult type 1 diabetic patients.
AIMS To determine adiponectin, leptin and resistin levels in type 1 diabetic patients. To evaluate their association with carotid intima media thickness (CIMT), an early marker of atherosclerosis and macrovascular disease.
Patient Selection 50 Type 1 diabetic patients –aged 30±8 yrs, F/M:18/32 –duration of diabetes 9 ±6.8 years –15 patients had microvascular complications –none had macrovascular complications 48 healthy controls –aged 33±7.5 yrs, F/M:20/28
Fasting blood glucose, A1c, creatinine, total cholesterol, triglyceride, HDL and LDL were measured. Adiponectin, leptin and resistin levels were determined by enzyme-linked immunosorbent assay. Carotid intima media thickness was measured by Doppler ultrasonography.
ControlType 1 Diabetes p Systolic BP (mmHg) 12.1 NS Diastolic BP (mmHg) 74.2 8.4 NS BMI (kg/m 2 ) 24.1 3.3 NS Demographic characteristics of the study groups
ControlType 1 Diabetes p FBG (mg/dL) 83.3 97.9 <0,0001 A1c (%) 4.5 1.9 <0,0001 Creatinine (mg/dL) 0.8 0.5 NS T Cholesterol (mg/dL) 32.3 NS Triglyceride (mg/dL) 109 58.4 NS HDL (mg/dL) 53.8 11.1 NS LDL (mg/dL) 92.6 26.0 NS Biochemical findings of the study groups
Adiponectin ( μg/mL ) p<0.05 Adiponectin levels of the study groups
Leptin ( ng/mL ) p<0.05 Leptin levels of the study groups
Resistin ( ng/mL ) Resistin levels of the study groups
CIMT of the study groups CIMT ( mm )
Adiponectin (μg/mL) r=-0.33 p<0.05 Resistin (ng/mL) Correlation Analysis of Adiponectin and Resistin with CIMT in Type 1 Diabetic Patients r=0.41, p<0.01 CIMT (mm)
Multivariate Analysis CIMT dependent variable corrected for BMI, HDL, TG, A1c relationship continues to hold for adiponectin and resistin (r 2 =0.44)
Complications There were no differences between the patients with microvascular complications and those without in terms of adiponectin, leptin and resistin levels.
Conclusions Adiponectin levels are increased and leptin levels are decreased in type 1 diabetic patients, in consistence with previous findings. Resistin levels are not different than controls. Adiponectin was associated negatively and resistin positively with CIMT.
Conclusions Although adiponectin levels are increased in type 1 diabetic patients with microvascular complications, they seem to decrease as CIMT increases, indicating the role of a different mechanism in macrovascular complications. This may be related to the antiatherosclerotic actions of adiponectin, but the pathogenesis of this mechanism remains to be elucidated in this population.