Association between adiponectin and low-grade albuminuria is BMI-dependent in type 2 diabetes.

Aim: Low-grade albuminuria is a marker of increased risk for both cardiovascular and renal disease. Adiponectin, with its insulin-sensitizing, anti-inflammatory and antiatherogenic properties, is associated with cardiovascular as well as renal disease. Limited and conflicting data exist on the association of adiponectin with low-grade albuminuria. Our aim was to explore the association of plasma adiponectin and low-grade albuminuria in patients with type 2 diabetes. Furthermore, we were interested whether this association is dependent upon insulin sensitivity.

Methods: In this cross-sectional study, plasma adiponectin and urinary albumin excretion rate (UAER) were determined in 71 patients by radioimmunoassay. Insulin sensitivity was measured by hyperinsulinemic euglycemic clamp and expressed as the M value. The relationship between variables was described using univariate and multiple linear regression.

Results: Adiponectin and UAER were negatively associated (R = -0.285, p < 0.05) only in patients with BMI >25. The association was independent of the clamp-derived M value, gender, BMI, arterial pressure or cholesterol.

Conclusion: In obese patients with type 2 diabetes, there is an inverse association between adiponectin and low-grade albuminuria, the association being independent of insulin resistance. The consequences of such a relationship in terms of renal disease progression and cardiovascular survival remain to be evaluated.