Relationship of clinical factors with adiponectin and leptin in children with newly diagnosed type 1 diabetes

摘要

Aim: To investigate potential predictors for adiponectin, leptin, and adiponectin/leptin ratio in children with newly diagnosed type 1 diabetes (T1D). udMethods: Medical records were reviewed from 175 subjects (165 Caucasian, 8 African American (AA), 59.4% male, mean age 9.7 ± 3.8 yrs) with new onset T1D diabetes diagnosed between January 2004 and December 2006 at Children’s Hospital of Pittsburgh of UPMC. Adiponectin, leptin, islet cell autoantibodies including ICA, glutamic acid decarboxylase (GAD) (65 kDa isoform), insulin antibody (IA2), insulin autoantibody (IAA) and zinc transporter 8 (ZnT8A), anthropometric and clinical variables including systolic and diastolic blood pressure, height, weight, waist circumference (with calculation of body mass index (BMI), waist percentile and waist/height ratio) and insulin dose, laboratory data including hemoglobin A1c(HbA1c), glucose, lipid profile (low-density lipoprotein (LDL) and high-density lipoprotein (HDL), cholesterol, and triglycerides) and C-peptide were all measured at 3 months after start of insulin therapy. HLA typing was determined for the presence of the DQ2 and/or DQ8 haplotypes. udResults: Univariate and multivariate linear regression analyses were performed assessing factors related with adiponectin and leptin, using two different procedures. Nine candidate models were identified and examined for consistency. Adiponectin was significantly associated with age, waist percentile and greater number of positive antibodies. Leptin was significantly associated with gender, BMI z-score, central obesity, C-peptide, GAD, HbA1c, and insulin dose adjusted by HbA1c. Adiponectin/leptin ratio was significantly associated with gender, age waist percentile, waist/height ratio, insulin dose adjusted by HbA1c, HbA1c, glucose, and C-peptide. udPublic health focused conclusion: Adiponectin, leptin and adiponectin/leptin ratio had different significant predictors. However there were a set of factors that where in common. Insulin resistance has been recognized to be present in youth with T1D. Adiponectin and leptin have an influence on insulin sensitivity. Identifying the significant predictors for these hormones may contribute to our understanding of their role in the pathogenesis of T1D. The identification of potential modifiable risk factors in children with this condition would be high priority. ud