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Sulwon Lecture 2018
Pathophysiology
Mitochondrial Dysfunction in Adipocytes as a Primary Cause of Adipose Tissue Inflammation
Chang-Yun Woo, Jung Eun Jang, Seung Eun Lee, Eun Hee Koh, Ki-Up Lee
Diabetes Metab J. 2019;43(3):247-256.   Published online March 27, 2019
DOI: https://doi.org/10.4093/dmj.2018.0221
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  • 260 Download
  • 70 Web of Science
  • 71 Crossref
AbstractAbstract PDFPubReader   

Adipose tissue inflammation is considered a major contributing factor in the development of obesity-associated insulin resistance and cardiovascular diseases. However, the cause of adipose tissue inflammation is presently unclear. The role of mitochondria in white adipocytes has long been neglected because of their low abundance. However, recent evidence suggests that mitochondria are essential for maintaining metabolic homeostasis in white adipocytes. In a series of recent studies, we found that mitochondrial function in white adipocytes is essential to the synthesis of adiponectin, which is the most abundant adipokine synthesized from adipocytes, with many favorable effects on metabolism, including improvement of insulin sensitivity and reduction of atherosclerotic processes and systemic inflammation. From these results, we propose a new hypothesis that mitochondrial dysfunction in adipocytes is a primary cause of adipose tissue inflammation and compared this hypothesis with a prevailing concept that “adipose tissue hypoxia” may underlie adipose tissue dysfunction in obesity. Recent studies have emphasized the role of the mitochondrial quality control mechanism in maintaining mitochondrial function. Future studies are warranted to test whether an inadequate mitochondrial quality control mechanism is responsible for mitochondrial dysfunction in adipocytes and adipose tissue inflammation.

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Original Article
Pathophysiology
Investigating Susceptibility to Diabetes Using Features of the Adipose Tissue in Response to In Utero Polycyclic Aromatic Hydrocarbons Exposure
Worlanyo E. Gato, Daniel A. Hunter, Shamaya L. Whitby, Christopher A. Mays, Wilson Yau
Diabetes Metab J. 2016;40(6):494-508.   Published online August 12, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.6.494
  • 3,757 View
  • 92 Download
  • 7 Web of Science
  • 5 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   
Background

In recent times, there has been an increase in the incidence of type 2 diabetes mellitus (T2DM) particularly in children. Adipocyte dysfunction provide a critical link between obesity and insulin resistance resulting in diabetes outcome. Further, environmental chemical exposure during early years of life might be a significant contributing factor to the increase in the incidence of T2DM. This study tests the idea that exposure to environmental contaminants (2-aminoanthracene [2AA]) in utero will show effects in the adipose tissue (AT) that signify T2DM vulnerability. 2AA is a polycyclic aromatic hydrocarbon found in a variety of products.

Methods

To accomplish the study objective, pregnant dams were fed various amounts of 2AA adulterated diets from gestation through postnatal period. The neonates and older offspring were analyzed for diabetic-like genes in the ATs and analysis of serum glucose. Furthermore, weight monitoring, histopathology and immunohistochemical (IHC) staining for CD68 in AT, adipocyte size determination and adiponectin amounts in serum were undertaken.

Results

Up-regulation of adiponectin and interleukin-6 genes were noted in the pups and older rats. Combination of intrauterine 2AA toxicity with moderate high fat diet exhibited gene expression patterns similar to those of the neonates. Elevated serum glucose levels were noted in treated groups. IHC of the AT indicated no significant malformations; however, CD68+ cells were greater in the animals treated to 2AA. Similarly, mean sizes of the adipocytes were larger in treated and combined 2AA and moderate high fat animals. Adiponectin was reduced in 2AA groups.

Conclusion

From the preceding, it appears intrauterine 2AA disturbance, when combined with excess fat accumulation will lead to greater risk for the diabetic condition.

Citations

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Reviews
Fibroblast Growth Factor 21 Protects against Atherosclerosis via Fine-Tuning the Multiorgan Crosstalk
Leigang Jin, Zhuofeng Lin, Aimin Xu
Diabetes Metab J. 2016;40(1):22-31.   Published online January 29, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.1.22
  • 4,859 View
  • 58 Download
  • 36 Web of Science
  • 32 Crossref
AbstractAbstract PDFPubReader   

Fibroblast growth factor 21 (FGF21) is a metabolic hormone with pleiotropic effects on energy metabolism and insulin sensitivity. Besides its antiobese and antidiabetic activity, FGF21 also possesses the protective effects against atherosclerosis. Circulating levels of FGF21 are elevated in patients with atherosclerosis, macrovascular and microvascular complications of diabetes, possibly due to a compensatory upregulation. In apolipoprotein E-deficient mice, formation of atherosclerotic plaques is exacerbated by genetic depletion of FGF21, but is attenuated upon replenishment with recombinant FGF21. However, the blood vessel is not the direct target of FGF21, and the antiatherosclerotic activity of FGF21 is attributed to its actions in adipose tissues and liver. In adipocytes, FGF21 promotes secretion of adiponectin, which in turn acts directly on blood vessels to reduce endothelial dysfunction, inhibit proliferation of smooth muscle cells and block conversion of macrophages to foam cells. Furthermore, FGF21 suppresses cholesterol biosynthesis and attenuates hypercholesterolemia by inhibiting the transcription factor sterol regulatory element-binding protein-2 in hepatocytes. The effects of FGF21 on elevation of adiponectin and reduction of hypercholesterolemia are also observed in a phase-1b clinical trial in patients with obesity and diabetes. Therefore, FGF21 exerts its protection against atherosclerosis by fine-tuning the interorgan crosstalk between liver, brain, adipose tissue, and blood vessels.

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Obesity and Metabolic Syndrome
Perspective of Small-Molecule AdipoR Agonist for Type 2 Diabetes and Short Life in Obesity
Miki Okada-Iwabu, Masato Iwabu, Kohjiro Ueki, Toshimasa Yamauchi, Takashi Kadowaki
Diabetes Metab J. 2015;39(5):363-372.   Published online October 22, 2015
DOI: https://doi.org/10.4093/dmj.2015.39.5.363
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AbstractAbstract PDFPubReader   

Obesity associated with unhealthy diet and lack of exercise is shown to contribute to the onset and/or aggravation of the metabolic syndrome and diabetes, thus placing affected individuals at increased risk of cardiovascular disease and cancer. Plasma adiponectin levels are decreased in obesity, which causes insulin resistance and diabetes. Therefore, we identified adiponectin receptors (AdipoRs) as the therapeutic target. It was suggested that, similarly to caloric restriction and exercise, activation of the AdipoRs may have the potential not only to improve lifestyle-related diseases but to contribute to prolonged the shortened lifespan on a high caloric unhealthy diet. To this end, we have identified "AdipoRon" as an adiponectin receptor agonist. Indeed, AdipoRon ameliorated diabetes associated with obesity as well as to increase exercise endurance, thus prolonging shortened lifespan of obese mice fed on a high fat diet. Additionally, we have recently determined the crystal structures of the human AdipoRs. The seven-transmembrane helices of AdipoRs are structurally distinct from those of G-protein coupled receptors. It is expected that these findings will contribute not only to the elucidation of the AdipoR-related signal transduction but to the development and optimization of AdipoR-targeted therapeutics for obesity-related diseases such as diabetes.

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Altered Transendothelial Transport of Hormones as a Contributor to Diabetes
Nanyoung Yoon, Thanh Q. Dang, Helen Chasiotis, Scott P. Kelly, Gary Sweeney
Diabetes Metab J. 2014;38(2):92-99.   Published online April 18, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.2.92
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AbstractAbstract PDFPubReader   

The vascular endothelium is a dynamic structure responsible for the separation and regulated movement of biological material between circulation and interstitial fluid. Hormones and nutrients can move across the endothelium either via a transcellular or paracellular route. Transcellular endothelial transport is well understood and broadly acknowledged to play an important role in the normal and abnormal physiology of endothelial function. However, less is known about the role of the paracellular route. Although the concept of endothelial dysfunction in diabetes is now widely accepted, we suggest that alterations in paracellular transport should be studied in greater detail and incorporated into this model. In this review we provide an overview of endothelial paracellular permeability and discuss its potential importance in contributing to the development of diabetes and associated complications. Accordingly, we also contend that if better understood, altered endothelial paracellular permeability could be considered as a potential therapeutic target for diabetes.

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Original Articles
Serum Adiponectin and Type 2 Diabetes: A 6-Year Follow-Up Cohort Study
Sun Ha Jee, Chul Woo Ahn, Jong Suk Park, Chang Gyu Park, Hyon-Suk Kim, Sang-Hak Lee, Sungha Park, Myoungsook Lee, Chang Beom Lee, Hye Soon Park, Heejin Kimm, Sung Hee Choi, Jidong Sung, Seungjoon Oh, Hyojee Joung, Sung Rae Kim, Ho-Joong Youn, Sun Mi Kim, Hong Soo Lee, Yejin Mok, Eunmi Choi, Young Duk Yun, Soo-Jin Baek, Jaeseong Jo, Kap Bum Huh
Diabetes Metab J. 2013;37(4):252-261.   Published online August 14, 2013
DOI: https://doi.org/10.4093/dmj.2013.37.4.252
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AbstractAbstract PDFPubReader   
Background

Studies on factors which may predict the risk of diabetes are scarce. This prospective cohort study was conducted to determine the association between adiponectin and type 2 diabetes among Korean men and women.

Methods

A total of 42,845 participants who visited one of seven health examination centers located in Seoul and Gyeonggi province, Republic of Korea between 2004 and 2008 were included in this study. The incidence rates of diabetes were determined through December 2011. To evaluate the effects of adiponectin on type 2 diabetes, the Cox proportional hazard model was used.

Results

Of the 40,005 participants, 959 developed type 2 diabetes during a 6-year follow-up. After the adjustment for age, body mass index (BMI), and waist circumference, the risks for type 2 diabetes in participants with normoglycemia had a 1.70-fold (95% confidence interval [CI], 1.21 to 2.38) increase in men and a 1.83-fold (95% CI, 1.17 to 2.86) increase in women with the lowest tertile of adiponectin when compared to the highest tertile of adiponectin. For participants with impaired fasting glucose (IFG), the risk for type 2 diabetes had a 1.46-fold (95% CI, 1.17 to 1.83) increase in men and a 2.52-fold (95% CI, 1.57 to 4.06) increase in women with the lowest tertile of adiponectin. Except for female participants with normoglycemia, all the risks remained significant after the adjustment for fasting glucose and other confounding variables. Surprisingly, BMI and waist circumference were not predictors of type 2 diabetes in men or women with IFG after adjustment for fasting glucose and other confounders.

Conclusion

A strong association between adiponectin and diabetes was observed. The use of adiponectin as a predictor of type 2 diabetes is considered to be useful.

Citations

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Relation of Absolute or Relative Adiposity to Insulin Resistance, Retinol Binding Protein-4, Leptin, and Adiponectin in Type 2 Diabetes
You Lim Kim, Tae Kyun Kim, Eun Sun Cheong, Dong Geum Shin, Gyu Sik Choi, Jihye Jung, Kyung-Ah Han, Kyung Wan Min
Diabetes Metab J. 2012;36(6):415-421.   Published online December 12, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.6.415
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AbstractAbstract PDFPubReader   
Background

Central fat mass (CFM) correlates with insulin resistance and increases the risk of type 2 diabetes and cardiovascular complications; however, peripheral fat mass (PFM) is associated with insulin sensitivity. The aim of this study was to investigate the relation of absolute and relative regional adiposity to insulin resistance index and adipokines in type 2 diabetes.

Methods

Total of 83 overweighted-Korean women with type 2 diabetes were enrolled, and rate constants for plasma glucose disappearance (KITT) and serum adipokines, such as retinol binding protein-4 (RBP4), leptin, and adiponectin, were measured. Using dual X-ray absorptiometry, trunk fat mass (in kilograms) was defined as CFM, sum of fat mass on the lower extremities (in kilograms) as PFM, and sum of CFM and PFM as total fat mass (TFM). PFM/TFM ratio, CFM/TFM ratio, and PFM/CFM ratio were defined as relative adiposity.

Results

Median age was 55.9 years, mean body mass index 27.2 kg/m2, and mean HbA1c level 7.12±0.84%. KITT was positively associated with PMF/TFM ratio, PMF/CFM ratio, and negatively with CFM/TFM ratio, but was not associated with TFM, PFM, or CFM. RBP4 levels also had a significant relationship with PMF/TFM ratio and PMF/CFM ratio. Adiponectin, leptin, and apolipoprotein A levels were related to absolute adiposity, while only adiponectin to relative adiposity. In correlation analysis, KITT in type 2 diabetes was positively related with HbA1c, fasting glucose, RBP4, and free fatty acid.

Conclusion

These results suggest that increased relative amount of peripheral fat mass may aggravate insulin resistance in type 2 diabetes.

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The Relationship of Adiponectin/Leptin Ratio with Homeostasis Model Assessment Insulin Resistance Index and Metabolic Syndrome in Apparently Healthy Korean Male Adults
Chan-Hee Jung, Eun-Jung Rhee, Ji-Hoon Choi, Ji-Cheol Bae, Seung-Hyun Yoo, Won-Jun Kim, Cheol-Young Park, Ji Oh Mok, Chul Hee Kim, Won-Young Lee, Ki-Won Oh, Sung-Woo Park, Sun-Woo Kim
Korean Diabetes J. 2010;34(4):237-243.   Published online August 31, 2010
DOI: https://doi.org/10.4093/kdj.2010.34.4.237
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AbstractAbstract PDFPubReader   
Background

We investigated the relationships of adiponectin/leptin (A/L) ratio with cardiovascular risk factors, insulin resistance index, and metabolic syndrome (MS) in apparently healthy Korean male adults.

Methods

Sixty-eight male subjects were enrolled among the participants of an annual health check-up program (mean age, 55.1 years). Percent body fat (%) was measured using a bioelectric impedance analyzer. Serum leptin level was measured via radioimmunoassay, and adiponectin level was measured using an enzyme-linked immunosorbent assay. Homeostasis model assessment (HOMA)-insulin resistance (IR) index was calculated, and the presence of metabolic syndrome was assessed.

Results

Adiponectin, leptin, and A/L ratio showed significant correlations with percent body fat, lipid profile, and HOMA-IR. Mean leptin and HOMA-IR levels were significantly higher, while A/L ratio was significantly lower in subjects with MS. With increasing number of MS components, the mean values of leptin and HOMA-IR increased and the A/L ratio decreased. In multiple regression analysis, HOMA-IR was significantly correlated with triglyceride, fasting glucose, and A/L ratio, while A/L ratio was significantly correlated with body mass index and HOMA-IR. HOMA-IR and A/L ratio were significant predictors for each other after adjustment for other factors.

Conclusion

A/L ratio correlated well with lipid profile, HOMA-IR, and the presence and number of MS components in Korean male subjects.

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Adipokine Concentrations in Pregnant Korean Women with Normal Glucose Tolerance and Gestational Diabetes Mellitus.
Eun Suk Oh, Jung Hee Han, Sung Min Han, Jee Aee Im, Eun Jung Rhee, Cheol Young Park, Ki Won Oh, Won Young Lee
Korean Diabetes J. 2009;33(4):279-288.   Published online August 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.4.279
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AbstractAbstract PDF
BACKGROUND
The aims of this study were to compare adipokine concentrations of pregnant women in the 24th~28th weeks of gestation to those of non-pregnant women. We compared the concentrations of adipokines in women with gestational diabetes mellitus (GDM), gestational impaired glucose tolerance (GIGT) and normal glucose tolerance (NGT). We also investigated the role of adipokines in the development of gestational glucose intolerance. METHODS: We surveyed 129 pregnant women who underwent a 100 g oral glucose tolerance test (OGTT) during the 24th~28th weeks of gestation. Participants were classified into three groups: (1) NGT (n = 40), (2) GIGT (n = 45), and (3) GDM (n = 44). Pregnant subjects with NGT were matched to non-pregnant controls for BMI and age (n = 41). RESULTS: Pregnant women with NGT exhibited significantly decreased adiponectin levels and elevated leptin levels compared to non-pregnant controls. Mean plasma resistin levels were significantly higher in women with GDM and GIGT than in women with NGT. Resistin and fasting glucose were significant predictors for the development of gestational glucose intolerance. CONCLUSION: Plasma adiponectin levels were decreased and leptin levels were increased in pregnant subjects with NGT compared to BMI and age matched non-pregnant controls. Women with GDM and GIGT exhibit significantly elevated concentrations of resistin compared with women with NGT. Increased resistin levels were also associated with the development of gestational glucose intolerance. Resistin may play an important role on the development of gestational glucose intolerance in Korean women.

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Adiponectin Concentrations in Type 2 Diabetic Patients with or without Metabolic Syndrome.
Ja Young Park, Ja Won Kim, Ji Min Kim, Ying Han, Soo Kyung Park, Ji Young Mok, Mi Kyoung Park, Hye Jeong Lee, Duk Kyu Kim
Korean Diabetes J. 2008;32(3):224-235.   Published online June 1, 2008
DOI: https://doi.org/10.4093/kdj.2008.32.3.224
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AbstractAbstract PDF
BACKGROUND
Adipocytes produce several adipokines that modulate insulin action as well as glucose and lipid metabolism. The aim of this study was to evaluate the relationship between serum adiponectin concentrations and metabolic syndrome (MS) in patients with type 2 diabetes mellitus. METHODS: This study included 127 type 2 diabetic patients (males 63, females 64). The subjects were divided into two groups as with or without metabolic syndrome (MS(+) or MS(-)). The MS was diagnosed by International Diabetes Federation. Serum adiponectin, leptin, fasting plasma insulin, glucose, glycated hemoglobin, lipid profile, white blood corpuscle (WBC), aspartate aminotransferase (AST), alanine aminotransferase (ALT), uric acid and C-reactive protein (CRP) were examined. RESULTS: Serum adiponectin concentrations were significantly lower in MS(+) than MS(-) (4.8 +/- 2.4 microgram/mL vs 7.6 +/- 5.8 microgram/mL, 7.6 +/- 3.7 microgram/mL vs 11.5 +/- 7.2 microgram/mL, P < 0.05 in males and females). After adjustment for age and body mass index (BMI), in MS (+), the serum levels of adiponectin correlated positively with high density lipoprotein - cholesterol (HDL-C) and negatively with height, body weight, ALT and CRP. In MS(-), the serum levels of adiponectin correlated positively with HDL-C and negatively with diastolic blood pressure (DBP), triglyceride and CRP. By multiple regression analysis, no parameters were independently correlated with serum adiponectin concentrations in MS(+), while DBP and HDL-C were independently related to serum adiponectin concentrations in MS(-). CONCLUSION: Serum adiponectin concentrations were lower in type 2 diabetic patients with MS than without MS. There were no significant parameters related to decrease serum adiponectin concentrations in MS. But further study is needed to confirm this result.

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  • Urinary adiponectin concentration is positively associated with micro- and macro-vascular complications
    Won Seon Jeon, Ji Woo Park, Namseok Lee, Se Eun Park, Eun Jung Rhee, Won Young Lee, Ki Won Oh, Sung Woo Park, Cheol-Young Park, Byung-Soo Youn
    Cardiovascular Diabetology.2013;[Epub]     CrossRef
  • Association of Plasma Osteoprotegerin with Adiponectin and Difference according to Obesity in Men with Metabolic Syndrome
    Woori Na, Cheongmin Sohn
    Korean Journal of Community Nutrition.2011; 16(6): 762.     CrossRef
  • The Effects of 12-Weeks Intensive Intervention Program on Cardiovascular Risk Factors, Adipocytokines and Nutrients Intakes in Industrial Male Workers
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    The Korean Journal of Nutrition.2011; 44(4): 292.     CrossRef
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    Korean Journal of Community Nutrition.2011; 16(1): 51.     CrossRef
  • Prevalence of Pancreatic Cancer in Diabetics and Clinical Characteristics of Diabetes-associated with Pancreatic Cancer - Comparison between Diabetes with and without Pancreatic Cancer -
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    The Korean Journal of Gastroenterology.2009; 54(3): 167.     CrossRef
Randomized Controlled Trial
Effects of Telmisartan Compared with Valsartan on Plasma Adiponectin Levels and Arterial Stiffness in Patients with Type 2 Diabetes: A Pilot Study.
Soo Yeon Park, Sin Gon Kim, Juri Park, Yun Jeong Lee, Hee Young Kim, Ji A Seo, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi
Korean Diabetes J. 2008;32(3):236-242.   Published online June 1, 2008
DOI: https://doi.org/10.4093/kdj.2006.32.3.236
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AbstractAbstract PDF
BACKGROUND
Telmisartan, used for the treatment of hypertension, has been shown to function as a partial agonist of peroxime proliferative activated receptor-nu (PPAR-nu). Theoretically, telmisartan which simultaneously blocks the angiotensin II receptor and activates PPAR-nu should be more effective in improving atherosclerotic surrogate markers than angiotensin II receptor blockers alone. Therefore, this pilot study was designed to evaluate and compare the efficacy of telmisartan and valsartan on plasma adiponectin levels and pulse wave velocity as a marker of arterial stiffness in patients with type 2 diabetes. METHODS: Thirty two patients with type 2 diabetes (mean duration 7.6 +/- 5.1 years) taking oral hypoglycemic agents were randomly assigned to receive telmisartan or valsartan for 12 weeks. RESULTS: Telmisartan and valsartan treatment significantly increased circulating adiponectin levels (P = 0.013 and P = 0.013, respectively) and reduced systolic (P = 0.001 and P = 0.002, respectively) and diastolic blood pressure (P = 0.001 and P < 0.001, respectively), and brachial-ankle PWV (P = 0.019 and P = 0.002, respectively), without significant differences between the two treatments. Before and after treatment, the fasting plasma glucose, interleukin-6, homeostasis model of assessment insulin resistance (HOMAIR) levels and lipid profile were unchanged in both treatment groups. CONCLUSION: Contrary to our expectation, telmisartan, even with its partial PPAR-nu activity, is not superior to valsartan in improving plasma adipocytokine levels and arterial stiffness in patients with type 2 diabetes. These data suggest that the partial PPAR-nu activity of telmisartan beyond valsartan may have less significant therapeutic implications than expected in treating patients with type 2 diabetes.
Review
Clinical Implication of Adiponectin.
Soo Lim, Hak Chul Jang
Korean Diabetes J. 2008;32(2):85-97.   Published online April 1, 2008
DOI: https://doi.org/10.4093/kdj.2008.32.2.85
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  • 5 Crossref
AbstractAbstract PDF
Adipose tissue is now considered as an active hormone-secreting organ, which secretes a number of biologically active adipokines such as free fatty acids, leptin, tumor necrosis factor alpha (TNFalpha), interleukin-6, plasminogen activator inhibitor-1, adiponectin and retinol binding protein 4 (RBP4). Among these, adiponectin has attracted considerable attention as an adipokine that has important role in the development of type 2 diabetes, atherosclerosis and cardiovascular diseases. Adiponectin was discovered to be the most abundant adipose-specific transcript. Many epidemiological and clinical studies have demonstrated that serum levels of adiponectin are inversely associated with body weight, especially abdominal visceral fat accumulation. Studies among Japanese and Pima Indians have reported lower concentrations of adiponectin in patients with type 2 diabetes than in those with normal glucose tolerance. A low level of adiponectin was found to be a significant risk factor for the development of cardiovascular events in the Korean patients with type 2 diabetes. We recently published that exercise, having an insulin-sensitizing effect, could be a good therapy to prevent or delay diabetes and cardiovascular diseases in middle-aged women through the modification of adiponectin. These results suggest that the clinical implication of adiponectin. A number of studies have been conducted to clarify the biological role of adiponectin. Recent studies have showed that adiponectin has anti-inflammatory, anti-atherogenic, and glucose-lowering properties. Taken together, it is conceivable that adiponectin plays as a backbone of metabolic syndrome. Finally, pleiotropic functions of adiponectin may possibly serve to prevent and treat atherosclerosis, type 2 diabetes and cardiovascular diseases. Furthermore, enhancement of adiponectin secretion or action may be a good therapeutic target for preventing type 2 diabetes or cardiovascular diseases.

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Original Articles
Association of Adiponectin and Hepatic Steatosis in Adults with Normal Transaminase Levels.
Jeong Hyun Mun, Seung Eun Lee, Ji Hyun Ahn, Soon Hyun Shinn
Korean Diabetes J. 2008;32(2):149-156.   Published online April 1, 2008
DOI: https://doi.org/10.4093/kdj.2008.32.2.149
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AbstractAbstract PDF
BACKGROUND
Nonalcoholic fatty liver disease (NAFLD) is associated with metabolic syndrome including insulin resistance, hypertension, dyslipidemia, central obesity, type 2 diabetes, and cardiovascular disease. In NAFLD, insulin resistance plays an important role in the progression of liver damage. In this study, we evaluated insulin resistance, plasma adiponectin, hepatic steatosis, and their association in adults with normal liver transaminase concentrations. METHODS: We analyzed 111 subjects, aged over 20 years old, who visited the Health Management Center at Chung-Ang University Hospital between May 2006 and August 2006. They had neither history nor clinical evidence of diabetes, cardiovascular or liver disease. They were divided into three groups by the degree of hepatic steatosis based on ultrasound findings. Anthropometric parameters were measured and blood samples were drawn after eight hours of fasting. RESULTS: Hepatic steatosis had a positive correlation with body mass index, waist circumference, blood pressure, triglycerides, HOMA-IR, and QUICKI. Moreover, it had a negative correlation with high-density lipoprotein cholesterol and adiponectin. Triglycerides, Adiponectin, and QUICKI were independent variables in predicting the degree of hepatic steatosis. CONCLUSION: This finding suggests that triglycerides and plasma adiponectin are independent predictors of hepatic steatosis in adults with normal liver transaminase concentrations.

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  • Analysis of Biochemical Markers Related to Fatty Liver Patients
    Jae-Hwan Cho, Jang-Sun Namgung, Jin Lee, Deog-Hwan Moon, Hae-Kag Lee
    Journal of Physical Therapy Science.2014; 26(12): 1865.     CrossRef
The Plasma Adiponectin Levels in Patients with Newly Diagnosed Type 2 Diabetes.
Ihn Suk Lee, Yun Jeung Kim, Jong Im Kim, Jea Hyung Park, Bon Jeong Ku, Kang Seo Park, Tae Yong Lee, Young Kun Kim
Korean Diabetes J. 2007;31(6):507-516.   Published online November 1, 2007
DOI: https://doi.org/10.4093/jkda.2007.31.6.507
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AbstractAbstract PDF
BACKGROUND
Adiponectin is secreted from adipose tissue and plays an important role in the regulation of glycemia and insulin resistance. In this study, the relationship between adiponectin and the adiposity, body composition, insulin sensitivity, lipid profile were respectively examined in newly diagnosed type 2 diabetes. METHODS: Total 1993 were participated in the Korea Rural Genomic Cohort Study (Geumsan County). After a 12-hour overnight fast, all subjects underwent 75-g oral glucose tolerance test. 105 of those were studied as newly diagnosed type 2 diabetes. The body composition was analyzed by means of bioelectric impedance analysis and the insulin sensitivity was estimated by fasting insulin, HOMA-IR and QUICKI method, respectively. RESULTS: Adiponectin positively correlated with high-density lipoprotein cholesterol (r = 0.246, P < 0.05). Adiponectin inversely associated with waist circumference (r = - 0.408, P < 0.01), triglyceride (r = -0.274, P < 0.05), ferritin (r = -0.260, P < 0.05), visceral fat (r = -0.248, P < 0.05), high sensitivity C-reactive protein (r = -0.228, P < 0.05) and body mass index (r = -0.225, P < 0.05). In multiple linear regression, waist circumference and high-density lipoprotein cholesterol were analyzed as independent variables of serum adiponectin. CONCLUSION: Adiponectin concentrations were closely related to waist circumference in newly diagnosed type 2 diabetes.
The Differences of Circulating Adiponectin Levels and Multimerization According to Obesity in Type 2 Diabetes Mellitus of Men.
Sang Ah Chang, Ho Young Son, Jung Min Lee, Tae Seo Sohn, Hyuk Sang Kwon, Hyun Shik Son, Kun Ho Yoon, Hee Seung Kim, Bong Yun Cha, Kwang Woo Lee
Korean Diabetes J. 2007;31(3):243-252.   Published online May 1, 2007
DOI: https://doi.org/10.4093/jkda.2007.31.3.243
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AbstractAbstract PDF
BACKGROUND
Adiponectin is adipose tissue derived hormone, which has been shown to play an important role in the regulation of glucose and lipid metabolism. Low adiponectin levels are associated with obesity and diabetes and coronary artery disease. In addition to adiponectin level, the adiponectin multimerization and its ratio to total adiponectin have also affect on metabolic risk factors and insulin resistance. However, the adiponectin multimerization pattern in type 2 diabetes of Korean has not been established. We investigated adiponectin levels and adiponectin multimerization pattern according to obesity in type 2 diabetes males of Korean. METHOD: The subjects of this study were 86 of diabetes patients and 89 of control subjects whose fasting blood glucose was below 110 mg/dL. They were divided into two subgroup, non-obese and obese, according to BMI (non-obese 25 < BMI). Anthropometric parameter and other metabolic risk factors were measured. Insulin resistance was presented by HOMA-IR. Plasma adiponectin level was measured by radioimmunoassay method. Adiponectin multimerization was fractionated by SDS-PAGE under non-reducing and non-heat denaturing state and performed immunoblotting. RESULT: Serum adiponectin levels were significantly reduced in obese than non obese group in diabetes patients (7.73 +/- 5.2 versus 12.56 +/- 8 microgram/mL, P = 0.003). Correlational analyses demonstrated that BMI, body weight, waist circumference, diastolic pressure, glucose and height correlated significantly with adiponectin levels in the diabetes patients. The HOMA-IR did not affect the plasma adiponectin levels in diabetic patients. There were no differences in adiponectin multimerization distribution and ratio between obese and non-obese group in the diabetes, however middle molecular weight multimers (MMW, ~110~160 Kda, hexamer) ratio in the control subjects were significantly reduced in obese group than non-obese group (49 +/- 9 versus 56 +/- 11%, P < 0.05). CONCLUSION: The adipoenctin levels were lower in obese than non-obese group of diabetes males in Korea. Aiponectin levels correlated with BMI and weight but not insulin resistance. The differences of adiponectin multimerization distribution and ratio between obese and non-obese group in diabetes were not detected.

Diabetes Metab J : Diabetes & Metabolism Journal