Aims/hypothesis  

Insulin resistance is related to an increased risk of diabetic retinopathy and nephropathy in type 1 diabetes. Patients with insulin resistance and/or macrovascular disease have abnormally low levels of adiponectin. The aim of this study was to investigate the relationships between adiponectin and renal and retinal diabetic complications in type 1 diabetic patients.

Methods  

In this 6-year prospective follow-up observational study, we evaluated the severity of retinopathy at baseline and determined the incident risk of microalbuminuria in 126 normoalbuminuric patients with type 1 diabetes. Each patient was age- and sex-matched to two non-diabetic control subjects.

Results  

Plasma adiponectin concentrations were significantly higher in diabetic subjects than in control subjects (p<0.0001). The adiponectin concentration was significantly higher in patients with severe diabetic retinopathy than in those without (39.1±14.0 vs 29.0±13.0 g/ml, p=0.0005). The 18 patients who developed persistent microalbuminuria had higher adiponectin concentrations than the other patients (35.8±14.5 vs 30.6±13.7 g/ml). Increased adiponectin concentrations were independently associated with the occurrence of microalbuminuria (p=0.0158) after adjustment for baseline urinary albumin concentration (p=0.004), sex (p=0.0054), blood pressure (NS) and metabolic control (NS).

Conclusions/interpretation  

The elevated adiponectin concentrations observed in subjects with microvascular disease may indicate an altered regulation of this adipocytokine in patients with complications associated with type 1 diabetes.