Changes in adiponectin level and fat distribution in patients with type 2 diabetes.

BACKGROUND: The aim of this study was to assess the impact of standard hypoglycaemic treatment strategies on adiponectin levels and fat distribution in patients with newly diagnosed type 2 diabetes mellitus (T2DM). MATERIAL AND METHODS: This was a prospective observational study of 50 women with newly diagnosed T2DM, aged 64·6 ± 7·9 years and treated for 12 months with lifestyle modification alone (n = 24) or in combination with metformin (n = 26), according to current standards of diabetic care and clinical practice guidelines. None of the patients required insulin therapy during the entire study period. Total (BF), abdominal (android) and hip (gynoid) fat were measured by dual-energy X-ray absorptiometry at the baseline and after 12 months of treatment. Total adiponectin, glycated haemoglobin (HbA1c) and fasting glucose were measured in 3-month intervals. RESULTS: Baseline adiponectin level was low (9·37 ± 2·81 µg/mL). Lifestyle modifications and metformin produced comparable changes in adiponectin levels, which were not associated with changes in BF, HbA1c, glucose and regional fat depots. Baseline adiponectin was inversely correlated with triglycerides (R = -0·441; P = 0·0007) and the android/gynoid ratio (R = -0·272; P = 0·042). Treatment with metformin was associated with a significant weight reduction (P = 0·033), which resulted from a decrease in BF% (P = 0·044) but was not associated with changes in android and gynoid depots. CONCLUSIONS: In postmenopausal women with newly diagnosed T2DM, lifestyle modifications alone or combined with metformin produced comparable changes in adiponectin levels. Weight reduction in patients treated with metformin was associated with significant decrease in %BF but not in regional fat depots.

The associations between cardiometabolic risk factors and visceral fat measured by a new dual-energy X-ray absorptiometry-derived method in lean healthy Caucasian women.

Excess visceral adipose tissue (VAT) is associated with a cluster of metabolic abnormalities. A new dual-energy X-ray absorptiometry (DXA)-based VAT measurement approach, CoreScan™, computes VAT mass and volume within the android region of a total body DXA scan. However, there have been no reference values developed for this method. The objective of this study was to determine the normal reference ranges for DXA-derived VAT in young, healthy, premenopausal women. We also sought associations between VAT, blood lipids, glucose, insulin and insulin resistance. In 120 randomly selected, normal weight, Caucasian women aged 20-40 years, we measured body fat (BF), VAT and lean mass by DXA. We also assessed blood pressure, waist and hip circumference, waist-to-hip ratio, body mass index, fasting glucose, insulin, triglycerides (TG), and high- (HDL) and low-density lipoproteins. Insulin resistance was evaluated by the homeostasis model assessment (HOMA). VAT mass accounted for 0.37 ± 0.3 % of weight and 1.11 ± 0.72 % of BF. Mean VAT mass and volume were 235.9 ± 183 g (95 % CI 202.7-269.1) and 250.3 ± 194.5 cm(3) (95 % CI 215.1-285.4), respectively. Anthropometric indices moderately correlated with VAT. VAT significantly correlated with HDL (R = -0.193; P = 0.03), glucose (R = 0.252; P = 0.005) and HOMA (R = 0.184; P = 0.049). In this study, we provide normal values of VAT mass and volume measured by DXA and determined for healthy, normal weight, Caucasian women aged 20-40 years. Even in such strictly selected population VAT correlated positively with insulin resistance and inversely with HDL.