This study sought to determine whether baseline adiponectin levels or intervention-associated increases in adiponectin levels were associated with progression to diabetes in the Diabetes Prevention Program (DPP). The DPP was a multicentre, randomized, clinical trial on the effect of intensive lifestyle changes (exercise and diet program targeting a weight loss of at least 7% total body weight) or 850 mg metformin twice daily vs. placebo on the rate of developing diabetes. In the DPP population of subjects at high risk for diabetes, baseline adiponectin levels were strongly inversely related to progression to diabetes in all treatment arms, independently of measures of adiposity. The DPP interventions increased adiponectin levels (0.83 ± 0.05 mg/ml in the lifestyle group, 0.23 ± 0.05 mg/ml in the metformin group, and 0.10 ± 0.05 mg/ml in the placebo group). The increase in adiponectin levels was more closely related to weight loss, but changes in adiponectin levels remained significant determinants of progression to diabetes after adjusting for baseline weight and change in weight. These observations support the notion that adiponectin is a powerful marker of diabetes risk in subjects at high risk for diabetes, even after adjusting for weight. However, the intervention-associated increases in adiponectin levels were comparatively small and less strongly related to diabetes outcome than baseline adiponectin levels.
Documentation centre