1
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Fumeron F, El Boustany R, Bastard JP, Fellahi S, Balkau B, Marre M, Venteclef N, Velho G, Roussel R. Plasma total adiponectin and changes in renal function in a cohort from the community: the prospective Data from an Epidemiological Study on the Insulin Resistance Syndrome study. Nephrol Dial Transplant 2021; 36:2058-2065. [PMID: 33141880 DOI: 10.1093/ndt/gfaa228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND High adiponectin levels are associated with diabetic nephropathy. Nevertheless, it is not known whether plasma adiponectin is associated with renal function decline in the general population. We evaluated whether adiponectin concentrations were associated with changes in renal function in a community cohort, the Data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR) study. METHODS Plasma adiponectin concentrations were measured in a random sample of 3284 people from the DESIR study, a 9-year prospective cohort from the general population. Data were analysed for three endpoints during follow-up: incidence of Stage 3 chronic kidney disease (CKD); the Kidney Disease: Improving Global Outcomes (KDIGO) criterion 'certain drop in eGFR' and rapid kidney function decline [estimated glomerular filtration rate (eGFR) slope steeper than -3 mL/min/1.73 m2/year]. RESULTS After exclusion of participants with an eGFR <60 mL/min/1.73 m2 at baseline and those with type 2 diabetes or impaired fasting glycaemia at any time during follow-up (remaining n = 2174), there was a 113% higher risk for a rapid decline in kidney function in participants with adiponectin above the third tertile (T3) versus below the first tertile (T1) (Ptrend = 0.004) and a 53% higher risk for kidney function decline as defined by the KDIGO criterion (Ptrend = 0.04). In a cross-sectional analysis, adiponectin was positively associated with urinary albumin:creatinine ratio at baseline (P = 0.009). CONCLUSIONS In a healthy cohort from the general population, higher levels of plasma adiponectin were associated with decreased renal function at baseline and at follow-up. This result is similar to what is observed in people with diabetic nephropathy, in contrast with animal models of nephropathy.
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Affiliation(s)
| | - Ray El Boustany
- Centre de Recherche des Cordeliers UMR-S 1138, Université de Paris, INSERM, Paris, France
| | - Jean-Philippe Bastard
- Biochemistry and Hormonology Department, AP-HP, Tenon Hospital, Paris, France.,Department of Biochemistry-Pharmacology-Molecular Biology-Medical Genetics, AP-HP, Henri Mondor Hospital, Créteil, France
| | - Soraya Fellahi
- Biochemistry and Hormonology Department, AP-HP, Tenon Hospital, Paris, France
| | - Beverley Balkau
- Centre for Research in Epidemiology and Population Health (CESP), INSERM, UMR-S 1018, University Paris-Sud, University Versailles Saint-Quentin, Villejuif, France
| | - Michel Marre
- Centre de Recherche des Cordeliers UMR-S 1138, Université de Paris, INSERM, Paris, France
| | - Nicolas Venteclef
- Centre de Recherche des Cordeliers UMR-S 1138, Université de Paris, INSERM, Paris, France.,UMR-S 1138, Sorbonne Université, Paris, France
| | | | - Ronan Roussel
- Centre de Recherche des Cordeliers UMR-S 1138, Université de Paris, INSERM, Paris, France.,Department of Diabetology, Endocrinology, Nutrition, AP-HP, Bichat Hospital, Paris, France
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2
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Pabalan N, Tiongco RE, Pandac JK, Paragas NA, Lasta SL, Gallego N, Jarjanazi H, Pineda-Cortel MR. Association and biomarker potential of elevated serum adiponectin with nephropathy among type 1 and type 2 diabetics: A meta-analysis. PLoS One 2018; 13:e0208905. [PMID: 30557306 PMCID: PMC6296550 DOI: 10.1371/journal.pone.0208905] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 11/26/2018] [Indexed: 12/21/2022] Open
Abstract
Background Managing nephropathy associated with diabetes mellitus warrant investigation of relevant biomarkers in predicting this condition. Adiponectin (ADP) may hold promise as a biomarker for diabetic nephropathy (DN). In this study, we examine associations of ADP with DN by meta-analyzing relevant literature. We also examined the predictive potential of ADP and estimate progression of DN. Methods Multi-database literature searches and serial omissions of articles yielded 13 studies for inclusion in the meta-analysis. We compared ADP levels between controls/ normoalbuminuria and cases with micro- and macroalbuminuria (MI and MA, respectively) as well as MI versus MA using standardized mean differences (SMD). Associations of ADP with DN were indicated with the P-value considered significant at ≤ 0.05. Subgrouping was based on diabetes type (1 and 2). Predictive potential of ADP was explored with AUC (area under the curve) derived from Receiver Operating Characteristic curve analysis. Results and conclusion At high P-values of <10−5, overall and subgroup outcomes indicated ADP associations with DN (up to SMD = 1.89–2.26, respectively). However, heterogeneity of the initial SMD effects (up to I2 = 99%) warranted examination of their sources which with the Galbraith plot method, either eliminated or reduced their heterogeneity, signifying combinability of the studies. This feature along with consistency of significant associations, robust outcomes and significant AUC values provide good evidence of the associative and predictive roles of ADP in DN.
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Affiliation(s)
- Noel Pabalan
- Center for Research and Development, Angeles University Foundation, Angeles City, Philippines
- * E-mail:
| | - Raphael Enrique Tiongco
- Department of Medical Technology, College of Allied Medical Professions, Angeles University Foundation, Angeles City, Philippines
- Graduate School, University of Santo Tomas, Manila City, Philippines
| | - Jefferyl Kae Pandac
- Graduate School, University of Santo Tomas, Manila City, Philippines
- Institute of Clinical Laboratory Sciences, Silliman University, Dumaguete, Philippines
| | - Noemi Anne Paragas
- Graduate School, University of Santo Tomas, Manila City, Philippines
- Institute of Clinical Laboratory Sciences, Silliman University, Dumaguete, Philippines
| | - Shamar Lo Lasta
- Graduate School, University of Santo Tomas, Manila City, Philippines
- Institute of Clinical Laboratory Sciences, Silliman University, Dumaguete, Philippines
| | - Nelven Gallego
- Graduate School, University of Santo Tomas, Manila City, Philippines
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila City, Philippines
| | - Hamdi Jarjanazi
- Environmental Monitoring and Reporting Branch, Ontario Ministry of the Environment and Climate Change, Toronto, Ontario, Canada
| | - Maria Ruth Pineda-Cortel
- Graduate School, University of Santo Tomas, Manila City, Philippines
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila City, Philippines
- Research Center for the Natural and Applied Sciences, University of Santo Tomas, Manila City, Philippines
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3
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Nicolas A, Mohammedi K, Bastard JP, Fellahi S, Bellili-Muñoz N, Roussel R, Hadjadj S, Marre M, Velho G, Fumeron F. T-cadherin gene variants are associated with nephropathy in subjects with type 1 diabetes. Nephrol Dial Transplant 2018; 32:1987-1993. [PMID: 28499019 DOI: 10.1093/ndt/gfx071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 03/16/2017] [Indexed: 01/08/2023] Open
Abstract
Background High plasma adiponectin levels are associated with diabetic nephropathy (DN). T-cadherin gene (CDH13) variants have been shown to be associated with adiponectin levels. We investigated associations between allelic variations of CDH13 and DN in subjects with type 1 diabetes. Methods Two CDH13 polymorphisms were analysed in 1297 Caucasian subjects with type 1 diabetes from the 'Survival Genetic Nephropathy' (SURGENE) (n = 340, 10-year follow-up), 'Genesis France-Belgium' (GENESIS) (n = 501, 5-year follow-up for n = 462) and 'Génétique de la Néphropathie Diabétique' (GENEDIAB) (n = 456, 9-year follow-up for n = 283) cohorts. Adiponectin levels were measured in plasma samples from GENESIS and GENEDIAB cohorts. Results Pooled analysis of GENEDIAB and GENESIS studies showed that baseline plasma adiponectin levels were higher in subjects with established/advanced DN at inclusion (P < 0.0001) and in subjects who developed end-stage renal disease (ESRD) at follow-up (P < 0.0001). The minor allele of rs3865188 was associated with lower adiponectin levels (P = 0.006). rs11646213 [odds ratio (OR) 1.47; 95% confidence interval (CI) 1.18-1.85; P = 0.0009] and rs3865188 (OR 0.71; 95% CI 0.57-0.90; P = 0.004) were associated with baseline prevalence of established/advanced DN. These polymorphisms were also associated with the risk of ESRD (0.006 < P < 0.03). The association between rs11646213 (but not rs3865188) and renal function remained significant after adjustment for plasma adiponectin. In SURGENE, rs11646213 [hazard ratio (HR) 1.69; 95% CI 1.01-2.71; P = 0.04] and rs3865188 (HR 0.74; 95% CI 0.55-0.99; P = 0.04) were associated with risk of renal events (defined as progression to more severe DN stages). Conclusions Plasma adiponectin levels are associated with the prevalence of DN and the incidence of ESRD in patients with type 1 diabetes. CDH13 polymorphisms are also associated with the prevalence and incidence of DN, and with the incidence of ESRD in these patients. The association between CDH13 and DN may be due to pleiotropic effects, both dependent and independent of plasma adiponectin levels.
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Affiliation(s)
- Anthony Nicolas
- INSERM, UMR-S 1138, Centre de Recherches des Cordeliers, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR-S 1138, Centre de Recherche des Cordeliers, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France
| | - Kamel Mohammedi
- INSERM, UMR-S 1138, Centre de Recherches des Cordeliers, Paris, France.,Univ Paris Diderot, Sorbonne Paris Cité, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France.,Department of Diabetology, Endocrinology and Nutrition, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean-Philippe Bastard
- Biochemistry and Hormonology Department, Tenon Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Soraya Fellahi
- Biochemistry and Hormonology Department, Tenon Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Ronan Roussel
- INSERM, UMR-S 1138, Centre de Recherches des Cordeliers, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR-S 1138, Centre de Recherche des Cordeliers, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France.,Univ Paris Diderot, Sorbonne Paris Cité, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France.,Department of Diabetology, Endocrinology and Nutrition, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Samy Hadjadj
- Université de Poitiers, UFR Médecine Pharmacie, CIC1402, Poitiers, France.,Department of Diabetology and Endocrinology, Pole DUNE & Centre d'investigation clinique, University Hospital, Poitiers, France.,INSERM, CIC1402, Poitiers, France
| | - Michel Marre
- INSERM, UMR-S 1138, Centre de Recherches des Cordeliers, Paris, France.,Univ Paris Diderot, Sorbonne Paris Cité, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France.,Department of Diabetology, Endocrinology and Nutrition, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Gilberto Velho
- INSERM, UMR-S 1138, Centre de Recherches des Cordeliers, Paris, France
| | - Frédéric Fumeron
- INSERM, UMR-S 1138, Centre de Recherches des Cordeliers, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR-S 1138, Centre de Recherche des Cordeliers, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France.,Univ Paris Diderot, Sorbonne Paris Cité, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France
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4
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Borges MC, Barros AJD, Ferreira DLS, Casas JP, Horta BL, Kivimaki M, Kumari M, Menon U, Gaunt TR, Ben-Shlomo Y, Freitas DF, Oliveira IO, Gentry-Maharaj A, Fourkala E, Lawlor DA, Hingorani AD. Metabolic Profiling of Adiponectin Levels in Adults: Mendelian Randomization Analysis. CIRCULATION. CARDIOVASCULAR GENETICS 2017; 10:e001837. [PMID: 29237687 PMCID: PMC5736126 DOI: 10.1161/circgenetics.117.001837] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 09/13/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Adiponectin, a circulating adipocyte-derived protein, has insulin-sensitizing, anti-inflammatory, antiatherogenic, and cardiomyocyte-protective properties in animal models. However, the systemic effects of adiponectin in humans are unknown. Our aims were to define the metabolic profile associated with higher blood adiponectin concentration and investigate whether variation in adiponectin concentration affects the systemic metabolic profile. METHODS AND RESULTS We applied multivariable regression in ≤5909 adults and Mendelian randomization (using cis-acting genetic variants in the vicinity of the adiponectin gene as instrumental variables) for analyzing the causal effect of adiponectin in the metabolic profile of ≤37 545 adults. Participants were largely European from 6 longitudinal studies and 1 genome-wide association consortium. In the multivariable regression analyses, higher circulating adiponectin was associated with higher high-density lipoprotein lipids and lower very-low-density lipoprotein lipids, glucose levels, branched-chain amino acids, and inflammatory markers. However, these findings were not supported by Mendelian randomization analyses for most metabolites. Findings were consistent between sexes and after excluding high-risk groups (defined by age and occurrence of previous cardiovascular event) and 1 study with admixed population. CONCLUSIONS Our findings indicate that blood adiponectin concentration is more likely to be an epiphenomenon in the context of metabolic disease than a key determinant.
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Affiliation(s)
- Maria Carolina Borges
- From the Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil (M.C.B., A.J.D.B., B.L.H., D.F.F., I.O.O.); MRC Integrative Epidemiology Unit (M.C.B., D.L.S.F., T.R.G., D.A.L.) and Population Health Sciences, Bristol Medical School (M.C.B., D.L.S.F., T.R.G., Y.B.-S., D.A.L.), University of Bristol, United Kingdom; Farr Institute of Health Informatics (J.P.C., A.D.H.), Department of Epidemiology and Public Health (M. Kivimaki, M. Kumari), Department of Women's Cancer, Institute for Women's Health, Faculty of Population Health Sciences (U.M., A.G.-M., E.F.), and Institute of Cardiovascular Science (A.D.H.), University College London, United Kingdom; Institute for Social and Economic Research, University of Essex, United Kingdom (M. Kumari); and Department of Physiology and Pharmacology, Institute of Biology, Federal University of Pelotas, Brazil (I.O.O.).
| | - Aluísio J D Barros
- From the Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil (M.C.B., A.J.D.B., B.L.H., D.F.F., I.O.O.); MRC Integrative Epidemiology Unit (M.C.B., D.L.S.F., T.R.G., D.A.L.) and Population Health Sciences, Bristol Medical School (M.C.B., D.L.S.F., T.R.G., Y.B.-S., D.A.L.), University of Bristol, United Kingdom; Farr Institute of Health Informatics (J.P.C., A.D.H.), Department of Epidemiology and Public Health (M. Kivimaki, M. Kumari), Department of Women's Cancer, Institute for Women's Health, Faculty of Population Health Sciences (U.M., A.G.-M., E.F.), and Institute of Cardiovascular Science (A.D.H.), University College London, United Kingdom; Institute for Social and Economic Research, University of Essex, United Kingdom (M. Kumari); and Department of Physiology and Pharmacology, Institute of Biology, Federal University of Pelotas, Brazil (I.O.O.)
| | - Diana L Santos Ferreira
- From the Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil (M.C.B., A.J.D.B., B.L.H., D.F.F., I.O.O.); MRC Integrative Epidemiology Unit (M.C.B., D.L.S.F., T.R.G., D.A.L.) and Population Health Sciences, Bristol Medical School (M.C.B., D.L.S.F., T.R.G., Y.B.-S., D.A.L.), University of Bristol, United Kingdom; Farr Institute of Health Informatics (J.P.C., A.D.H.), Department of Epidemiology and Public Health (M. Kivimaki, M. Kumari), Department of Women's Cancer, Institute for Women's Health, Faculty of Population Health Sciences (U.M., A.G.-M., E.F.), and Institute of Cardiovascular Science (A.D.H.), University College London, United Kingdom; Institute for Social and Economic Research, University of Essex, United Kingdom (M. Kumari); and Department of Physiology and Pharmacology, Institute of Biology, Federal University of Pelotas, Brazil (I.O.O.)
| | - Juan Pablo Casas
- From the Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil (M.C.B., A.J.D.B., B.L.H., D.F.F., I.O.O.); MRC Integrative Epidemiology Unit (M.C.B., D.L.S.F., T.R.G., D.A.L.) and Population Health Sciences, Bristol Medical School (M.C.B., D.L.S.F., T.R.G., Y.B.-S., D.A.L.), University of Bristol, United Kingdom; Farr Institute of Health Informatics (J.P.C., A.D.H.), Department of Epidemiology and Public Health (M. Kivimaki, M. Kumari), Department of Women's Cancer, Institute for Women's Health, Faculty of Population Health Sciences (U.M., A.G.-M., E.F.), and Institute of Cardiovascular Science (A.D.H.), University College London, United Kingdom; Institute for Social and Economic Research, University of Essex, United Kingdom (M. Kumari); and Department of Physiology and Pharmacology, Institute of Biology, Federal University of Pelotas, Brazil (I.O.O.)
| | - Bernardo Lessa Horta
- From the Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil (M.C.B., A.J.D.B., B.L.H., D.F.F., I.O.O.); MRC Integrative Epidemiology Unit (M.C.B., D.L.S.F., T.R.G., D.A.L.) and Population Health Sciences, Bristol Medical School (M.C.B., D.L.S.F., T.R.G., Y.B.-S., D.A.L.), University of Bristol, United Kingdom; Farr Institute of Health Informatics (J.P.C., A.D.H.), Department of Epidemiology and Public Health (M. Kivimaki, M. Kumari), Department of Women's Cancer, Institute for Women's Health, Faculty of Population Health Sciences (U.M., A.G.-M., E.F.), and Institute of Cardiovascular Science (A.D.H.), University College London, United Kingdom; Institute for Social and Economic Research, University of Essex, United Kingdom (M. Kumari); and Department of Physiology and Pharmacology, Institute of Biology, Federal University of Pelotas, Brazil (I.O.O.)
| | - Mika Kivimaki
- From the Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil (M.C.B., A.J.D.B., B.L.H., D.F.F., I.O.O.); MRC Integrative Epidemiology Unit (M.C.B., D.L.S.F., T.R.G., D.A.L.) and Population Health Sciences, Bristol Medical School (M.C.B., D.L.S.F., T.R.G., Y.B.-S., D.A.L.), University of Bristol, United Kingdom; Farr Institute of Health Informatics (J.P.C., A.D.H.), Department of Epidemiology and Public Health (M. Kivimaki, M. Kumari), Department of Women's Cancer, Institute for Women's Health, Faculty of Population Health Sciences (U.M., A.G.-M., E.F.), and Institute of Cardiovascular Science (A.D.H.), University College London, United Kingdom; Institute for Social and Economic Research, University of Essex, United Kingdom (M. Kumari); and Department of Physiology and Pharmacology, Institute of Biology, Federal University of Pelotas, Brazil (I.O.O.)
| | - Meena Kumari
- From the Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil (M.C.B., A.J.D.B., B.L.H., D.F.F., I.O.O.); MRC Integrative Epidemiology Unit (M.C.B., D.L.S.F., T.R.G., D.A.L.) and Population Health Sciences, Bristol Medical School (M.C.B., D.L.S.F., T.R.G., Y.B.-S., D.A.L.), University of Bristol, United Kingdom; Farr Institute of Health Informatics (J.P.C., A.D.H.), Department of Epidemiology and Public Health (M. Kivimaki, M. Kumari), Department of Women's Cancer, Institute for Women's Health, Faculty of Population Health Sciences (U.M., A.G.-M., E.F.), and Institute of Cardiovascular Science (A.D.H.), University College London, United Kingdom; Institute for Social and Economic Research, University of Essex, United Kingdom (M. Kumari); and Department of Physiology and Pharmacology, Institute of Biology, Federal University of Pelotas, Brazil (I.O.O.)
| | - Usha Menon
- From the Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil (M.C.B., A.J.D.B., B.L.H., D.F.F., I.O.O.); MRC Integrative Epidemiology Unit (M.C.B., D.L.S.F., T.R.G., D.A.L.) and Population Health Sciences, Bristol Medical School (M.C.B., D.L.S.F., T.R.G., Y.B.-S., D.A.L.), University of Bristol, United Kingdom; Farr Institute of Health Informatics (J.P.C., A.D.H.), Department of Epidemiology and Public Health (M. Kivimaki, M. Kumari), Department of Women's Cancer, Institute for Women's Health, Faculty of Population Health Sciences (U.M., A.G.-M., E.F.), and Institute of Cardiovascular Science (A.D.H.), University College London, United Kingdom; Institute for Social and Economic Research, University of Essex, United Kingdom (M. Kumari); and Department of Physiology and Pharmacology, Institute of Biology, Federal University of Pelotas, Brazil (I.O.O.)
| | - Tom R Gaunt
- From the Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil (M.C.B., A.J.D.B., B.L.H., D.F.F., I.O.O.); MRC Integrative Epidemiology Unit (M.C.B., D.L.S.F., T.R.G., D.A.L.) and Population Health Sciences, Bristol Medical School (M.C.B., D.L.S.F., T.R.G., Y.B.-S., D.A.L.), University of Bristol, United Kingdom; Farr Institute of Health Informatics (J.P.C., A.D.H.), Department of Epidemiology and Public Health (M. Kivimaki, M. Kumari), Department of Women's Cancer, Institute for Women's Health, Faculty of Population Health Sciences (U.M., A.G.-M., E.F.), and Institute of Cardiovascular Science (A.D.H.), University College London, United Kingdom; Institute for Social and Economic Research, University of Essex, United Kingdom (M. Kumari); and Department of Physiology and Pharmacology, Institute of Biology, Federal University of Pelotas, Brazil (I.O.O.)
| | - Yoav Ben-Shlomo
- From the Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil (M.C.B., A.J.D.B., B.L.H., D.F.F., I.O.O.); MRC Integrative Epidemiology Unit (M.C.B., D.L.S.F., T.R.G., D.A.L.) and Population Health Sciences, Bristol Medical School (M.C.B., D.L.S.F., T.R.G., Y.B.-S., D.A.L.), University of Bristol, United Kingdom; Farr Institute of Health Informatics (J.P.C., A.D.H.), Department of Epidemiology and Public Health (M. Kivimaki, M. Kumari), Department of Women's Cancer, Institute for Women's Health, Faculty of Population Health Sciences (U.M., A.G.-M., E.F.), and Institute of Cardiovascular Science (A.D.H.), University College London, United Kingdom; Institute for Social and Economic Research, University of Essex, United Kingdom (M. Kumari); and Department of Physiology and Pharmacology, Institute of Biology, Federal University of Pelotas, Brazil (I.O.O.)
| | - Deise F Freitas
- From the Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil (M.C.B., A.J.D.B., B.L.H., D.F.F., I.O.O.); MRC Integrative Epidemiology Unit (M.C.B., D.L.S.F., T.R.G., D.A.L.) and Population Health Sciences, Bristol Medical School (M.C.B., D.L.S.F., T.R.G., Y.B.-S., D.A.L.), University of Bristol, United Kingdom; Farr Institute of Health Informatics (J.P.C., A.D.H.), Department of Epidemiology and Public Health (M. Kivimaki, M. Kumari), Department of Women's Cancer, Institute for Women's Health, Faculty of Population Health Sciences (U.M., A.G.-M., E.F.), and Institute of Cardiovascular Science (A.D.H.), University College London, United Kingdom; Institute for Social and Economic Research, University of Essex, United Kingdom (M. Kumari); and Department of Physiology and Pharmacology, Institute of Biology, Federal University of Pelotas, Brazil (I.O.O.)
| | - Isabel O Oliveira
- From the Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil (M.C.B., A.J.D.B., B.L.H., D.F.F., I.O.O.); MRC Integrative Epidemiology Unit (M.C.B., D.L.S.F., T.R.G., D.A.L.) and Population Health Sciences, Bristol Medical School (M.C.B., D.L.S.F., T.R.G., Y.B.-S., D.A.L.), University of Bristol, United Kingdom; Farr Institute of Health Informatics (J.P.C., A.D.H.), Department of Epidemiology and Public Health (M. Kivimaki, M. Kumari), Department of Women's Cancer, Institute for Women's Health, Faculty of Population Health Sciences (U.M., A.G.-M., E.F.), and Institute of Cardiovascular Science (A.D.H.), University College London, United Kingdom; Institute for Social and Economic Research, University of Essex, United Kingdom (M. Kumari); and Department of Physiology and Pharmacology, Institute of Biology, Federal University of Pelotas, Brazil (I.O.O.)
| | - Aleksandra Gentry-Maharaj
- From the Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil (M.C.B., A.J.D.B., B.L.H., D.F.F., I.O.O.); MRC Integrative Epidemiology Unit (M.C.B., D.L.S.F., T.R.G., D.A.L.) and Population Health Sciences, Bristol Medical School (M.C.B., D.L.S.F., T.R.G., Y.B.-S., D.A.L.), University of Bristol, United Kingdom; Farr Institute of Health Informatics (J.P.C., A.D.H.), Department of Epidemiology and Public Health (M. Kivimaki, M. Kumari), Department of Women's Cancer, Institute for Women's Health, Faculty of Population Health Sciences (U.M., A.G.-M., E.F.), and Institute of Cardiovascular Science (A.D.H.), University College London, United Kingdom; Institute for Social and Economic Research, University of Essex, United Kingdom (M. Kumari); and Department of Physiology and Pharmacology, Institute of Biology, Federal University of Pelotas, Brazil (I.O.O.)
| | - Evangelia Fourkala
- From the Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil (M.C.B., A.J.D.B., B.L.H., D.F.F., I.O.O.); MRC Integrative Epidemiology Unit (M.C.B., D.L.S.F., T.R.G., D.A.L.) and Population Health Sciences, Bristol Medical School (M.C.B., D.L.S.F., T.R.G., Y.B.-S., D.A.L.), University of Bristol, United Kingdom; Farr Institute of Health Informatics (J.P.C., A.D.H.), Department of Epidemiology and Public Health (M. Kivimaki, M. Kumari), Department of Women's Cancer, Institute for Women's Health, Faculty of Population Health Sciences (U.M., A.G.-M., E.F.), and Institute of Cardiovascular Science (A.D.H.), University College London, United Kingdom; Institute for Social and Economic Research, University of Essex, United Kingdom (M. Kumari); and Department of Physiology and Pharmacology, Institute of Biology, Federal University of Pelotas, Brazil (I.O.O.)
| | - Debbie A Lawlor
- From the Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil (M.C.B., A.J.D.B., B.L.H., D.F.F., I.O.O.); MRC Integrative Epidemiology Unit (M.C.B., D.L.S.F., T.R.G., D.A.L.) and Population Health Sciences, Bristol Medical School (M.C.B., D.L.S.F., T.R.G., Y.B.-S., D.A.L.), University of Bristol, United Kingdom; Farr Institute of Health Informatics (J.P.C., A.D.H.), Department of Epidemiology and Public Health (M. Kivimaki, M. Kumari), Department of Women's Cancer, Institute for Women's Health, Faculty of Population Health Sciences (U.M., A.G.-M., E.F.), and Institute of Cardiovascular Science (A.D.H.), University College London, United Kingdom; Institute for Social and Economic Research, University of Essex, United Kingdom (M. Kumari); and Department of Physiology and Pharmacology, Institute of Biology, Federal University of Pelotas, Brazil (I.O.O.)
| | - Aroon D Hingorani
- From the Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil (M.C.B., A.J.D.B., B.L.H., D.F.F., I.O.O.); MRC Integrative Epidemiology Unit (M.C.B., D.L.S.F., T.R.G., D.A.L.) and Population Health Sciences, Bristol Medical School (M.C.B., D.L.S.F., T.R.G., Y.B.-S., D.A.L.), University of Bristol, United Kingdom; Farr Institute of Health Informatics (J.P.C., A.D.H.), Department of Epidemiology and Public Health (M. Kivimaki, M. Kumari), Department of Women's Cancer, Institute for Women's Health, Faculty of Population Health Sciences (U.M., A.G.-M., E.F.), and Institute of Cardiovascular Science (A.D.H.), University College London, United Kingdom; Institute for Social and Economic Research, University of Essex, United Kingdom (M. Kumari); and Department of Physiology and Pharmacology, Institute of Biology, Federal University of Pelotas, Brazil (I.O.O.)
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Ortega Moreno L, Copetti M, Fontana A, De Bonis C, Salvemini L, Trischitta V, Menzaghi C. Evidence of a causal relationship between high serum adiponectin levels and increased cardiovascular mortality rate in patients with type 2 diabetes. Cardiovasc Diabetol 2016; 15:17. [PMID: 26817832 PMCID: PMC4730617 DOI: 10.1186/s12933-016-0339-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 01/18/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Despite its beneficial role on insulin resistance and atherosclerosis, adiponectin has been repeatedly reported as an independent positive predictor of cardiovascular mortality. METHODS A Mendelian randomization approach was used, in order to evaluate whether such counterintuitive association recognizes a cause-effect relationship. To this purpose, single nucleotide polymorphism rs822354 in the ADIPOQ locus which has been previously associated with serum adiponectin at genome-wide level, was used as an instrument variable. Our investigation was carried out in the Gargano Heart Study-prospective design, comprising 356 patients with type 2 diabetes, in whom both total and high molecular weight (HMW) adiponectin were measured and cardiovascular mortality was recorded (mean follow-up = 5.4 ± 2.5 years; 58 events/1922 person-year). RESULTS The A allele of rs822354 was associated with both total and HMW adiponectin [β (SE) = 0.10 (0.042), p = 0.014 and 0.17 (0.06), p = 0.003; respectively]. In a Poisson model comprising age, sex, smoking habits, BMI, HbA1c, total cholesterol, HDL-cholesterol, triglycerides, insulin therapy and hypertension, both rs822354 (IRR = 1.94, 95 % CI 1.23-3.07; p = 0.005), as well as the genetic equivalent of total adiponectin change (IRR = 1.07, 95 % CI 1.02-1.12; p = 0.003) were significantly associated with cardiovascular mortality. The observed genetic effect was significantly greater than that exerted by the genetic equivalent change of serum adiponectin (p for IRR heterogeneity = 0.012). In the above-mentioned adjusted model, very similar results were obtained when HMW, rather than total, adiponectin was used as the exposure variable of interest. CONCLUSIONS Our data suggest that the paradoxical association between high serum adiponectin levels and increased cardiovascular mortality rate is based on a cause-effect relationship, thus pointing to an unexpected deleterious role of adiponectin action/metabolism on atherosclerotic processes.
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Affiliation(s)
- Lorena Ortega Moreno
- Research Unit of Diabetes and Endocrine Diseases, IRCCS Casa Sollievo della Sofferenza, Viale Padre Pio, 71013, San Giovanni Rotondo, Italy.
| | - Massimiliano Copetti
- Unit of Biostatistics, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
| | - Andrea Fontana
- Unit of Biostatistics, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
| | - Concetta De Bonis
- Research Unit of Diabetes and Endocrine Diseases, IRCCS Casa Sollievo della Sofferenza, Viale Padre Pio, 71013, San Giovanni Rotondo, Italy.
| | - Lucia Salvemini
- Research Unit of Diabetes and Endocrine Diseases, IRCCS Casa Sollievo della Sofferenza, Viale Padre Pio, 71013, San Giovanni Rotondo, Italy.
| | - Vincenzo Trischitta
- Research Unit of Diabetes and Endocrine Diseases, IRCCS Casa Sollievo della Sofferenza, Viale Padre Pio, 71013, San Giovanni Rotondo, Italy. .,Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
| | - Claudia Menzaghi
- Research Unit of Diabetes and Endocrine Diseases, IRCCS Casa Sollievo della Sofferenza, Viale Padre Pio, 71013, San Giovanni Rotondo, Italy.
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Ortega Moreno L, Lamacchia O, Copetti M, Salvemini L, De Bonis C, De Cosmo S, Cignarelli M, Trischitta V, Menzaghi C. Serum Adiponectin and Glomerular Filtration Rate in Patients with Type 2 Diabetes. PLoS One 2015; 10:e0140631. [PMID: 26465607 PMCID: PMC4605700 DOI: 10.1371/journal.pone.0140631] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 09/29/2015] [Indexed: 12/20/2022] Open
Abstract
High serum adiponectin has been increased in several conditions of kidney disease. Only sparse and conflicting results have been reported in patients with type 2 diabetes (T2D), a subgroup of individuals who are at high risk for renal dysfunction. The aim of this study was to fill up this gap of knowledge by investigating such association in a large sample of Italian diabetic patients. The association between serum adiponectin levels and estimated glomerular filtration rate (eGFR by Chronic Kidney Disease-Epidemiology Collaboration CKD-EPI equation) was investigated in 1,243 patients with T2D from two cross-sectional Italian studies: 878 from San Giovanni Rotondo (SGR) and 365 from Foggia (FG). Serum adiponectin was inversely associated with eGFR in SGR [β (standard error, SE) for 1 standard deviation (SD) of adiponectin = -3.26 (0.64)] and in FG [β(SE)=-5.70(1.28)] sample, as well as in the two studies combined [β(SE)=-3.99(0.59)];(p<0.0001 for all). In this combined analysis, the association was still significant after adjusting for sex, smoking habits, body mass index (BMI), waist circumference, diabetes duration, glycated hemoglobin (HbA1c), albumin creatinine ratio (ACR) and anti-hyperglycemic, anti-hypertensive and anti-dyslipidemic treatments [β (SE)= -2.19 (0.59), p = 0.0001]. A stronger association between each SD adiponectin increment and low eGFR was observed among patients with micro-/macro-albuminuria, as compared to those with normo-albuminuria [adjusted β(SE)=-4.42(1.16) ml/min/1.73m2 vs. -1.50 (0.67) ml/min/1.73m2, respectively; p for adiponectin-by-albuminuric status = 0.022]. For each adiponectin SD increment, the odds of having eGFR < 60 ml/min/1.73m2 increased by 41% (odds ratio, OR = 1.41; 95% confidence interval, CI 1.21–1.64) in SGR sample, 53% (OR = 1.53; 95% CI 1.21–1.94) in FG sample, and 44% (OR = 1.44; 95%CI 1.27–1.64) in the two studies considered together (p<0.0001 for all). In the combined sample, further adjustment for the above mentioned covariates did not change the observed association (OR = 1.36; 95%CI 1.16–1.60; p<0.0001). Our study, so far the largest addressing the relationship between serum adiponectin and GFR in T2D, strongly suggests that the paradoxical inverse association, previously reported in different clinical sets, is also observed in diabetic patients. Further studies are needed to unravel the biology underlying this counterintuitive relationship.
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Affiliation(s)
- Lorena Ortega Moreno
- Research Unit of Diabetes and Endocrine Diseases, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Olga Lamacchia
- Unit of Endocrinology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Massimiliano Copetti
- Unit of Biostatistics, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Lucia Salvemini
- Research Unit of Diabetes and Endocrine Diseases, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Concetta De Bonis
- Research Unit of Diabetes and Endocrine Diseases, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Salvatore De Cosmo
- Division of Internal Medicine, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Italy
| | - Mauro Cignarelli
- Unit of Endocrinology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Vincenzo Trischitta
- Research Unit of Diabetes and Endocrine Diseases, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
- * E-mail: (CM); (VT)
| | - Claudia Menzaghi
- Research Unit of Diabetes and Endocrine Diseases, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
- * E-mail: (CM); (VT)
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7
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Treatment-Induced Changes in Plasma Adiponectin Do Not Reduce Urinary Albumin Excretion in the Diabetes Prevention Program Cohort. PLoS One 2015; 10:e0136853. [PMID: 26312480 PMCID: PMC4551844 DOI: 10.1371/journal.pone.0136853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 08/07/2015] [Indexed: 12/15/2022] Open
Abstract
Background and Objectives Molecular data suggests that adiponectin may directly regulate urinary albumin excretion. In the Diabetes Prevention Program (DPP) we measured adiponectin and albuminuria before and after intervention, and we previously reported increases in adiponectin with interventions. Here we have used the DPP dataset to test the hypothesis that treatment-related increases in adiponectin may reduce albuminuria in obesity. Design, Setting, Participants and Methods We evaluated cross-sectional correlations between plasma adiponectin and urinary albumin excretion at baseline, and the relationship of treatment-related changes in adiponectin and albuminuria. Baseline and follow-up urine albumin to creatinine ratios (ACR (albumin to creatinine ratio)) and plasma adiponectin concentration were available in 2553 subjects. Results Adjusting for age, sex and race/ethnicity, we observed a statistically significant but weak inverse relationship between adiponectin and ACR at baseline (conditional Spearman’s rho = (-) 0.04, p = 0.04). Although DPP treatments significantly increased plasma adiponectin, there were no treatment effects on ACR and no differences in ACR across treatment groups. There was a weak direct (not inverse) association between change in adiponectin and change in albuminuria (adjusted Spearman’s rho = (+) 0.04, p = 0.03). Conclusions In a large, well-characterized cohort of obese dysglycemic subjects we observed a weak inverse association between circulating adiponectin concentrations and urinary albumin excretion at baseline. Contrary to the hypothesized effect, treatment-related increases in plasma adiponectin were not associated with a reduction in ACR. The association of change in adiponectin with change in ACR should be assessed in populations with overt albuminuria before excluding a beneficial effect of increasing adiponectin to reduce ACR in obesity.
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8
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Boef AGC, Dekkers OM, le Cessie S. Mendelian randomization studies: a review of the approaches used and the quality of reporting. Int J Epidemiol 2015; 44:496-511. [PMID: 25953784 DOI: 10.1093/ije/dyv071] [Citation(s) in RCA: 248] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Mendelian randomization (MR) studies investigate the effect of genetic variation in levels of an exposure on an outcome, thereby using genetic variation as an instrumental variable (IV). We provide a meta-epidemiological overview of the methodological approaches used in MR studies, and evaluate the discussion of MR assumptions and reporting of statistical methods. METHODS We searched PubMed, Medline, Embase and Web of Science for MR studies up to December 2013. We assessed (i) the MR approach used; (ii) whether the plausibility of MR assumptions was discussed; and (iii) whether the statistical methods used were reported adequately. RESULTS Of 99 studies using data from one study population, 32 used genetic information as a proxy for the exposure without further estimation, 44 performed a formal IV analysis, 7 compared the observed with the expected genotype-outcome association, and 1 used both the latter two approaches. The 80 studies using data from multiple study populations used many different approaches to combine the data; 52 of these studies used some form of IV analysis; 44% of studies discussed the plausibility of all three MR assumptions in their study. Statistical methods used for IV analysis were insufficiently described in 14% of studies. CONCLUSIONS Most MR studies either use the genotype as a proxy for exposure without further estimation or perform an IV analysis. The discussion of underlying assumptions and reporting of statistical methods for IV analysis are frequently insufficient. Studies using data from multiple study populations are further complicated by the combination of data or estimates. We provide a checklist for the reporting of MR studies.
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Affiliation(s)
- Anna G C Boef
- Department of Clinical Epidemiology, Department of Endocrinology and Metabolic Diseases, and Department of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Leiden, The Netherlands.
| | - Olaf M Dekkers
- Department of Clinical Epidemiology, Department of Endocrinology and Metabolic Diseases, and Department of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Leiden, The Netherlands. Department of Clinical Epidemiology, Department of Endocrinology and Metabolic Diseases, and Department of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Saskia le Cessie
- Department of Clinical Epidemiology, Department of Endocrinology and Metabolic Diseases, and Department of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Leiden, The Netherlands. Department of Clinical Epidemiology, Department of Endocrinology and Metabolic Diseases, and Department of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Leiden, The Netherlands
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9
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Prudente S, Morini E, Lucchesi D, Lamacchia O, Bailetti D, Mercuri L, Alberico F, Copetti M, Pucci L, Fariello S, Giusti L, Cignarelli M, Penno G, De Cosmo S, Trischitta V. IRS1 G972R missense polymorphism is associated with failure to oral antidiabetes drugs in white patients with type 2 diabetes from Italy. Diabetes 2014; 63:3135-40. [PMID: 24947357 DOI: 10.2337/db13-1966] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study tried to replicate in a large sample of white patients with type 2 diabetes (T2D) from Italy a previously reported association of the IRS1 G972R polymorphism with failure to oral antidiabetes drugs (OAD). A total of 2,409 patients from four independent studies were investigated. Case subjects (n = 1,193) were patients in whom, because of uncontrolled diabetes (i.e., HbA1c >8%), insulin therapy had been added either on, or instead of, maximal or near-maximal doses of OAD, mostly metformin and sulfonylureas; control subjects (n = 1,216) were patients with HbA1c <8% in the absence of insulin therapy. The IRS1 G972R polymorphism was typed by TaqMan allele discrimination. In all samples, individuals carrying the IRS1 R972 risk variant tended to be more frequent among case than control subjects, though reaching statistical significance only in one case. As no IRS1 G972R-by-study sample interaction was observed, data from the four samples were analyzed together; a significant association was observed (allelic odds ratio [OR] 1.30, 95% CI 1.03-1.63). When our present data were meta-analyzed with those obtained in a previous study, an overall R972 allelic OR of 1.37 (1.12-1.69) was observed. This study confirms in a large and ethnically homogeneous sample that IRS1 G972R polymorphism is associated with failure to OAD among patients with T2D.
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Affiliation(s)
- Sabrina Prudente
- Mendel Laboratory, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Eleonora Morini
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Daniela Lucchesi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Olga Lamacchia
- Unit of Endocrinology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Diego Bailetti
- Mendel Laboratory, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Luana Mercuri
- Mendel Laboratory, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Federica Alberico
- Mendel Laboratory, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Massimiliano Copetti
- Unit of Biostatistics, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Laura Pucci
- Institute of Agricultural Biology and Biotechnology, CNR, Pisa, Italy
| | - Stefania Fariello
- Unit of Endocrinology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Laura Giusti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Mauro Cignarelli
- Unit of Endocrinology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Giuseppe Penno
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Salvatore De Cosmo
- Clinical Unit of Endocrinology, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Vincenzo Trischitta
- Mendel Laboratory, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy Department of Experimental Medicine, Sapienza University, Rome, Italy Research Unit of Diabetes and Endocrine Diseases, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
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10
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Abstract
Adiponectin is a 30-kDa polypeptide secreted primarily by adipose tissue and plays a key role in kidney disease. In obesity, reduced adiponectin levels are associated with insulin resistance, cardiovascular disease and obesity related kidney disease. The latter includes microalbuminuria, glomerulomegaly, overt proteinuria and focal segmental glomerulosclerosis. Adiponectin levels in type 2 diabetics also negatively correlate with early features of nephropathy. However, in patients with established chronic kidney disease, adiponectin levels are elevated and positively predict progression of disease. The mechanism of action of adiponectin in the kidney appears to be related to AMPK activation and NADPH oxidase. Further studies are needed to elucidate this pathway and investigate the role of potential targets of adiponectin-AMPK-Nox pathway for CKD as obesity-related CKD is increasing worldwide.
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Affiliation(s)
- Natalie Sweiss
- Center for Renal Translational Medicine, Institute of Metabolomic Medicine, Division of Nephrology-Hypertension, Department of Medicine, University of California, San Diego and VA Medical Center La Jolla, 9500 Gilman Drive, MC 0711, La Jolla, CA 92093, USA.
| | - Kumar Sharma
- Center for Renal Translational Medicine, Institute of Metabolomic Medicine, Division of Nephrology-Hypertension, Department of Medicine, University of California, San Diego and VA Medical Center La Jolla, 9500 Gilman Drive, MC 0711, La Jolla, CA 92093, USA.
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11
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Gao H, Fall T, van Dam RM, Flyvbjerg A, Zethelius B, Ingelsson E, Hägg S. Evidence of a causal relationship between adiponectin levels and insulin sensitivity: a Mendelian randomization study. Diabetes 2013; 62:1338-44. [PMID: 23274890 PMCID: PMC3609596 DOI: 10.2337/db12-0935] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The adipocyte-secreted protein adiponectin is associated with insulin sensitivity in observational studies. We aimed to evaluate whether this relationship is causal using a Mendelian randomization approach. In a sample of Swedish men aged 71 years (n = 942) from the Uppsala Longitudinal Study of Adult Men (ULSAM), insulin sensitivity (M/I ratio) was measured by the euglycemic insulin clamp. We used three genetic variants in the ADIPOQ locus as instrumental variables (IVs) to estimate the potential causal effect of adiponectin on insulin sensitivity and compared these with results from conventional linear regression. The three ADIPOQ variants, rs17300539, rs3774261, and rs6444175, were strongly associated with serum adiponectin levels (all P ≤ 5.3 × 10(-9)) and were also significantly associated with M/I ratio in the expected direction (all P ≤ 0.022). IV analysis confirmed that genetically determined adiponectin increased insulin sensitivity (β = 0.47-0.81, all P ≤ 0.014) comparable with observational estimates (β = 0.50, all P(difference) ≥ 0.136). Adjustment for BMI and waist circumference partly explained the association of both genetically determined and observed adiponectin levels with insulin sensitivity. The observed association between higher adiponectin levels and increased insulin sensitivity is likely to represent a causal relationship partly mediated by reduced adiposity.
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Affiliation(s)
- He Gao
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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12
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De Cosmo S, Menzaghi C, Prudente S, Trischitta V. Role of insulin resistance in kidney dysfunction: insights into the mechanism and epidemiological evidence. Nephrol Dial Transplant 2012; 28:29-36. [PMID: 23048172 DOI: 10.1093/ndt/gfs290] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Several lines of evidence suggest a pathogenic role of insulin resistance on kidney dysfunction. Potential mechanisms are mostly due to the effect of single abnormalities related to insulin resistance and clustering into the metabolic syndrome. Hyperinsulinemia, which is inevitably associated to insulin resistance in non diabetic states, also appears to play a role on kidney function by inducing glomerular hyperfiltration and increased vascular permeability. More recently, adipocytokine which are linked to insulin resistance, low grade inflammation, endothelial dysfunction and vascular damage have been proposed as additional molecules able to modulate kidney function. In addition, recent evidences point also to a role of insulin resistance at the level of the podocyte, an important player in early phases of diabetic kidney damage, thus suggesting a new mechanism through which a reduction of insulin action can affect kidney function. In fact, mouse models not expressing the podocyte insulin receptor develop podocytes apoptosis, effacement of its foot processes along with thickening of the glomerular basement membrane, increased glomerulosclerosis and albuminuria. A great number of epidemiological studies have repeatedly reported the association between insulin resistance and kidney dysfunction in both non diabetic and diabetic subjects. Among these, studies addressing the impact of insulin resistance genes on kidney dysfunction have played the important role to help establish a cause-effect relationship between these two traits. Finally, numerous independent intervention studies have shown that a favourable modulation of insulin resistance has a positive effect also on urinary albumin and total protein excretion. In conclusion, several data of different nature consistently support the role of insulin resistance and related abnormalities on kidney dysfunction. Intervention trials designed to investigate whether treating insulin resistance ameliorates also hard renal end-points are both timely and needed.
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Affiliation(s)
- S De Cosmo
- Unit of Endocrinology, IRCSS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
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13
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Menzaghi C, Salvemini L, Fini G, Thompson R, Mangiacotti D, Di Paola R, Morini E, Giorelli M, De Bonis C, De Cosmo S, Doria A, Trischitta V. Serum resistin and kidney function: a family-based study in non-diabetic, untreated individuals. PLoS One 2012; 7:e38414. [PMID: 22701635 PMCID: PMC3373540 DOI: 10.1371/journal.pone.0038414] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Accepted: 05/07/2012] [Indexed: 11/21/2022] Open
Abstract
Background High serum resistin levels have been associated with kidney dysfunction. Most of these studies have been carried out in individuals with severe kidney impairment, diabetes, cardiovascular disease and related treatments. Thus, the observed association might have been influenced by these confounders. Our aim was to study the relationship between serum resistin, urinary albumin/creatinine ratio (ACR) and glomerular filtration rate (GFR) in a family-based sample, the Gargano Family Study (GFS) of 635 non diabetic, untreated Whites. Methods A linear mixed effects model and bivariate analyses were used to evaluate the phenotypic and genetic relations between serum resistin and both ACR and eGFR. All analyses were adjusted for sex, age, age squared, BMI, systolic blood pressure, smoking habits and physical exercise. Results After adjustments, resistin levels were slightly positively associated with ACR (β±SE = 0.049±0.023, p = 0.035) and inversely related to eGFR (β±SE = −1.43±0.61, p = 0.018) levels. These associations remained significant when either eGFR or ACR were, reciprocally, added as covariates. A genetic correlation (ρg = −0.31±0.12; adjusted p = 0.013) was observed between resistin and eGFR (but not ACR) levels. Conclusion Serum resistin levels are independently associated with ACR and eGFR in untreated non-diabetic individuals. Serum resistin and eGFR share also some common genetic background. Our data strongly suggest that resistin plays a role in modulating kidney function.
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Affiliation(s)
- Claudia Menzaghi
- Research Unit of Diabetes and Endocrine Disease, IRCCS Casa Sollievo della Sofferenza San Giovanni Rotondo, Italy
- * E-mail: (CM); (VT)
| | - Lucia Salvemini
- Research Unit of Diabetes and Endocrine Disease, IRCCS Casa Sollievo della Sofferenza San Giovanni Rotondo, Italy
| | - Grazia Fini
- Research Unit of Diabetes and Endocrine Disease, IRCCS Casa Sollievo della Sofferenza San Giovanni Rotondo, Italy
| | - Ryan Thompson
- Research Division, Joslin Diabetes Center, Boston, Massachusetts, United States of America
| | - Davide Mangiacotti
- Research Unit of Diabetes and Endocrine Disease, IRCCS Casa Sollievo della Sofferenza San Giovanni Rotondo, Italy
| | - Rosa Di Paola
- Research Unit of Diabetes and Endocrine Disease, IRCCS Casa Sollievo della Sofferenza San Giovanni Rotondo, Italy
| | - Eleonora Morini
- Research Unit of Diabetes and Endocrine Disease, IRCCS Casa Sollievo della Sofferenza San Giovanni Rotondo, Italy
| | - Maddalena Giorelli
- Research Unit of Diabetes and Endocrine Disease, IRCCS Casa Sollievo della Sofferenza San Giovanni Rotondo, Italy
| | - Concetta De Bonis
- Research Unit of Diabetes and Endocrine Disease, IRCCS Casa Sollievo della Sofferenza San Giovanni Rotondo, Italy
| | - Salvatore De Cosmo
- Unit of Endocrinology, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Alessandro Doria
- Research Division, Joslin Diabetes Center, Boston, Massachusetts, United States of America
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Vincenzo Trischitta
- Research Unit of Diabetes and Endocrine Disease, IRCCS Casa Sollievo della Sofferenza San Giovanni Rotondo, Italy
- Mendel Laboratory, IRCSS Casa Sollievo della Sofferenza, Rome, Italy
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
- * E-mail: (CM); (VT)
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