RESUMO
Hypoadiponectinemia is associated with insulin resistance and predicts the incidence of type 2 diabetes and coronary artery disease. Chronic subclinical inflammation and activation of innate immunity are involved in the pathogenesis of type 2 diabetes. Since obesity is associated with hypoadiponectinemia and with increased circulating levels of various immunological markers, which are both major risk factors for the development of type 2 diabetes, so the aim of this study was to investigate the association of hypoadiponectinemia and low grade systemic inflammation in type 2 diabetic patients as well as subjects with impaired glucose tolerance. Sixty male age matched subjects were included in the study. They were divided into 3 groups each of twenty as follows: newly diagnosed patients with type 2 diabetes mellitus [group I], patients with impaired glucose tolerance [group II] and healthy subjects with normal glucose tolerance [group Ill] as a control group. Patients and controls were subjected to full history taking, clinical examination stressing on blood pressure, BMI and WHR; laboratory investigations including FPG, PPG, HbA1C, fasting insulin and HOMA-IR index, lipid profile [TG, total cholesterol, HDL-C, LDL-C], serum uric acid, serum adiponectin and some immunological markers including WBC, acute phase reactants [CRP], TN F-alpha and eotaxin. In type 2 diabetic patients, plasma adiponectin levels were strongly negatively correlated with CRP, fasting TG, fasting insulin, HOMA-IR and fasting glucose [P < 0.001] and strongly positively correlated with HDL-cholesterol [P < 0.001]. Inverse correlations were found between adiponectin levels and WHR, postprandial glucose, and TNF-alpha [P < 0.05]. No significant correlation was found between adiponectin level and eotaxin [P > 0.05]. In subjects with IGT, an inverse relation was found between adiponectin and fasting glucose [P < 0.05]. The mean values of immunological markers [eotaxin, TNF-alpha, CRP and WBC] were significantly higher in type 2 diabetics versus control group. Subjects with IGT showed significant lower levels of eotaxin and TNF-alpha than diabetic patients, while they showed significant higher levels of eotaxin, TN F-alpha and CRP than controls [P < 0.05]. The mean value of adiponectin was significantly lower in type 2 diabetic patients than in subjects with IGT and the control group [P < 0.05]. The studied clinical and anthropometric parameters, lipid profile, parameters of glycemic control, fasting insulin and HOMA-IR were significantly higher in group I versus group II and the control group [P < 0.05]. Our results support the hypothesis that hypoadiponectinemia may be associated with low grade inflammation, metabolic abnormalities and dyslipidemia. Therefore, adiponectin may be an important link between inflammation and type 2 diabetes as it was negatively correlated with markers of inflammation in such patients