Serum adiponectin level in children with type 1 diabetes mellitus: Relationship to metabolic control and pubertal development

Objective: Adiponectin, a recently discovered cytokine, is produced exclusively by adipocytes that regulate energy homeostasis and play a role in glucose and lipid metabolism. It also has anti-inflammatory and anti-atherogenic properties. Investigations on adult diabetic patients showed that adiponectin levels were correlated with insulin resistance, metabolic control, and complications.The complications in patients with type 1 DM are correlated with levels of HbA1c in serum samples. Thus these complications are likely to arise during the puberty as a result of deterioration in the metabolic control. We planned to investigate the relationship between adiponectin level and metabolic control and complications in pubertal type 1 diabetic patients.Aims: The aim of the study was to measure serum adiponectin concentrations in children with type 1 diabetes mellitus and to investigate their relationship with HbA1c, duration of diabetes, insulin doses, pubertal stages, lipid profile and sex.Patients and methods: Adiponectin concentration was determined in 60 diabetic children with type 1 diabetes mellitus who had diabetes for at least 2 years.(26 boys, 34girls; 5.68-18 years of age) and 42 controls (18 boys, 24 girls; 5.97-18 years of age). Serum adiponectin concentration was determined by a RIA kit provided from Linco (USA).Results: The diabetic patients had significantly higher serum adiponectin levels than the healthy controls (35.70±12.40 µg/ml vs 14.27±6.39 µg/ml; p<0.0001).There were no significant differences in serum adiponectin levels between the group of diabetic patients with good metabolic control (HbA1c<8%) and group of the bad metabolic controls (HbA1c?8%) (p=0.41).There were no significant differences in serum adiponectin levels between prepubertal and pubertal children with type 1 diabetes mellitus. There was no difference in adiponectin levels at any stage of puberty among patients with type 1 DM.In this study no correlation was found between serum adiponectin levels and HbA1c levels, the duration of the diabetes, mean insulin requirement and lipid levels. There was no significant gender difference in adiponectin concentrations among diabetic patients and control subjects.Conclusions: Many clinical studies indicate that adiponectin levels are even higher in type 1 diabetic patients suffering from microvascular complications. Thus, patients with nephropathy or retinopathy had higher levels of adiponectin than patients without these complications. That is to say, serum adiponectin levels were elevated in all diabetic subgroups, irrespective of the presence of complications. In this study, we found that serum adiponectin levels with diabetic children without complications had significantly higher than control subjects. But we couldn?t find any relationship between adiponectin and metabolic control, insulin doses, and pubertal stages in our patients.The increase in serum adiponectin levels in children with type 1 DM could not be understood the physiopathology therefore; we considered that experimental and clinical research needs to be done.