Endocrine Abstracts

Introduction: A subclinical inflammatory state in obesity may be the link between diabetes mellitus (DM) and atherogenesis. This study aimed to investigate the relationship between pro atherogenic factors (C reactive protein (CRP), interleukine 6 (IL-6), vascular adhesion molecular type 1 (VCAM-1)), and anti-atherogenic factor adiponectin in subjects with obesity and DM.

Methods: One hundred and twelve subjects (51 men, 103 women) were enrolled: group DM (lean subject with DM, n=21), group OB (obese nondiabetic subjects, n=52, BMI≥27 kg/m²) and group OB+DM (obese diabetic subjects, n=49). A health group of 32 subjects with normal BMI was the control group (CG). CRP, IL-6, VCAM-1, adiponectin, glucose and lipid profile were determined in blood. Body composition was estimated by BIA.

Results: Obese subjects had higher CRP (OB=6.6±4.3 and OB+DM=6.0±4.0 versus GC=1.7±2.0, P<0.001), VCAM-1 (OB=518±122.5 versus CG=453.8±119, P<0.001), and lower adiponectin (OB=0.87±0.17; OB+DM=0.88±0.19 versus GC=1.04±0.19, P<0.001) and HDL (OB+DM=46.4±0.2 and OB=48±0.4 versus CG=55±3.0, P<0.001). DM subjects had lower adiponectin (DM=0.91±0.21 and OB+DM=0.88±0.19 versus CG=1.04±0.19, P<0.001) and higher VCAM-1 (DM=570±132 and OB+DM=572±158 versus GC=453.8±119, P<0.001), TG (DM=157±45 and OB+DM=176±11.9 versus GC=83±40 P<0.001) and total cholesterol (DM=230±37 and OB+DM=220±36 versus GC=206±37, P<0.001). IL-6 was not significantly different between groups. Multivariate analysis adjusted for sex and age showed that adiponectin was inversely and independently associated with BMI (r=−0.300, P=0.003) and directly with HDL (r=0.299, P=0.024) in the whole population. Adiponectin was inversely and independently associated with TG only in OB+DM group (r=−0.224, P=0.028). CRP was independently associated with visceral fat and total body fat (r=0.610, P=0.0001) in DM groups. The VCAM1 was not correlated with any variable.

Conclusion: We found significant increases on pro atherogenic markers CRP and VCAM-1 in obese subjects, as well as decreases on protective factors adiponectin and HDL, independent of the presence of type 2 diabetes.