The impact of leptin and adiponectin on incident type 2 diabetes is modified by sex and insulin resistance

• Background Adiponectin and leptin and their ratio have been associated with incident type 2 diabetes (T2DM), although presented data are conflicting and populations studied have been small. In this large prospective nested case referent study, we hypothesised that these associations are sex-specific and may be modified by insulin resistance. Methods Men and women aged 30–60 years with incident T2DM (n=640) and a prior health survey within the Västerbotten Intervention Programme (VIP), and matched referents (n=1564) were identified. Using conditional logistic regression analyses, we tested whether baseline plasma adiponectin and leptin levels and their ratio independently predicted incident T2DM, stratified for gender and insulin resistance. Results Adjusted for traditional risk factors, fourth-quartile levels of adiponectin were associated with a reduced risk of T2DM in men (OR 0.55 [0.36–0.86]) and women (OR 0.47 [0.27–0.83]). Quartile four of the leptin/adiponectin ratio predicted T2DM in both men (OR 3.08 [1.68–5.67]) and women (OR 3.31 [1.56–7.03]), while quartile-four levels of leptin predicted T2DM only in men (OR 2.30 [1.32–4.02]). When stratified for insulin sensitivity and adjusted for BMI, loge-transformed leptin predicted T2DM in insulin-sensitive men (OR 1.56 [1.13–2.17]) but not in insulin-resistant men (OR 1.03 [0.76–1.39]). The effect of adiponectin and the leptin/adiponectin ratio was not influenced by the insulin sensitivity status. Conclusions Leptin in men and adiponectin in both sexes were independent predictors of T2DM. The association was modified by the degree of insulin sensitivity. The leptin/adiponectin ratio may add predictive information beyond the separate hormones

Nyckelord

adiponectin

leptin

leptin/adiponectin ratio

diabetes mellitus

insulin resistance

Publikations- och innehållstyp

vet (ämneskategori)

ovr (ämneskategori)