Korean J Intern Med.  2018 Mar;33(2):367-382. 10.3904/kjim.2016.114.

Long-term study of the association of adipokines and glucose variability with diabetic complications

Affiliations
  • 1Department of Nephrology, Korea University Ansan Hospital, Ansan, Korea. starch70@korea.ac.kr

Abstract

BACKGROUND/AIMS
Recent studies have suggested an important role of adipokines in the development of insulin resistance and diabetes mellitus. The clinical relevance of adipokines on long-term outcomes in patients with diabetes and chronic kidney disease is uncertain. The purpose of this study was to identify a predictable factor in patients with long-term diabetic complications.
METHODS
A total of 161 diabetic individuals were followed-up from 2002 to 2013. Circulating plasma levels of adiponectin, glypican-4, irisin, visfatin, and visit-to-visit glucose variability were measured in diabetic patients. Associations among adipokines and variable metabolic parameters and microvascular, and macrovascular complications were evaluated.
RESULTS
Plasma adiponectin and glypican-4 levels were significantly increased in patients with renal insufficiency. These adipokines were negatively associated with estimated glomerular filtration rate and positively associated with urinary albumin excretion. The relative risk of renal progression to dialysis increased independently with increasing level of adiponectin. Glypican-4 and visfatin were not predictive of any microvascular or macrovascular complications. Glucose variability increased the risk of diabetic nephropathy and cerebrovascular complications.
CONCLUSIONS
Adiponectin and glypican-4 were associated with renal function and might be able to predict renal progression. Glucose variability was a predictable factor for diabetic nephropathy and cerebrovascular complications.

Keyword

Adipokines; Adiponectin; Glypicans; Glucose variability; Diabetes complications

MeSH Terms

Adipokines*
Adiponectin
Diabetes Complications*
Diabetes Mellitus
Diabetic Nephropathies
Dialysis
Glomerular Filtration Rate
Glucose*
Glypicans
Humans
Insulin Resistance
Nicotinamide Phosphoribosyltransferase
Plasma
Renal Insufficiency
Renal Insufficiency, Chronic
Adipokines
Adiponectin
Glucose
Glypicans
Nicotinamide Phosphoribosyltransferase
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