Association between Adiponectin and Low-Grade Albuminuria Is BMI-Dependent in Type 2 Diabetes

Aim: Low-grade albuminuria is a marker of increased risk for both cardiovascular and renal disease. Adiponectin, with its insulin-sensitizing, anti-inflammatory and antiatherogenic properties, is associated with cardiovascular as well as renal disease. Limited and conflicting data exist on the association of adiponectin with low-grade albuminuria. Our aim was to explore the association of plasma adiponectin and low-grade albuminuria in patients with type 2 diabetes. Furthermore, we were interested whether this association is dependent upon insulin sensitivity. Methods: In this cross-sectional study, plasma adiponectin and urinary albumin excretion rate (UAER) were determined in 71 patients by radioimmunoassay. Insulin sensitivity was measured by hyperinsulin-emic euglycemic clamp and expressed as the M value. The relationship between variables was described using univariate and multiple linear regression. Results: Adiponectin and UAER were negatively associated (R = -0.285, p < 0.05) only in patients with BMI > 25. The association was independent of the clamp-derived M value, gender, BMI, arterial pressure or cholesterol. Conclusion: In obese patients with type 2 diabetes, there is an inverse association between adiponectin and low-grade albuminuria, the association being independent of insulin resistance. The consequences of such a relationship in terms of renal disease progression and cardiovascular survival remain to be evaluated. Copyright (C) 2010 S. Karger AG, Basel