Biomed Res Int. 2014;2014:701915. doi 10.1155/2014/701915.

Adiponectin, leptin, and chemerin in elderly patients with type 2 diabetes mellitus: a close linkage with obesity and length of the disease.
 

Susana Coimbra1, Jorge Brandão Proença2, Alice Santos-Silva3, Maria João Neuparth4.

  • 1Instituto de Biologia Molecular e Celular (IBMC), Universidade do Porto, Rua do Campo Alegre 823, 4150 Porto, Portugal ; CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS), Rua Central da Gandra 1317, 4585-116 Gandra, Portugal.
  • 2CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS), Rua Central da Gandra 1317, 4585-116 Gandra, Portugal.
  • 3Instituto de Biologia Molecular e Celular (IBMC), Universidade do Porto, Rua do Campo Alegre 823, 4150 Porto, Portugal ; Laboratório de Bioquímica, Departamento de Ciências Biológicas, Faculdade de Farmácia (FFUP), Universidade do Porto, Rua de Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal.
  • 4CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS), Rua Central da Gandra 1317, 4585-116 Gandra, Portugal ; Centro de Investigação em Actividade Física, Saúde e Lazer (CIAFEL), Universidade do Porto, Rua Dr. Plácido Costa 91, 4200-450 Porto, Portugal.

 

Abstract

Obesity, insulin resistance, and aging are closely associated and adipokines seem to have a crucial role in their pathophysiology. We aim to study the relationship between aging and chemerin, adiponectin, and leptin levels in type 2 diabetes mellitus (T2DM). Age correlated positively with chemerin and leptin and inversely with adiponectin. Body mass index (BMI) correlated positively with leptin (in males) and chemerin and inversely with adiponectin. The patients with ≥ 65 years (n = 34) showed significantly higher leptin and chemerin and lower adiponectin levels than middle-aged (38-64 years) patients (n = 39) and controls (n = 20). After statistical adjustment for length of disease, there was a loss of significance, between T2DM groups, for adiponectin and, in female, for leptin. In the older group, BMI correlated with adiponectin and with leptin, but not with chemerin. Adiponectin and leptin levels in elderly T2DM patients seem to be closely linked to obesity and to length of the disease. In elderly T2DM patients, chemerin concentrations are increased and seem to be independent of length of disease and BMI, suggesting that adipocyte dysfunction is enhanced with aging. The understanding of the glucose homeostasis impairment in the elderly is mandatory in order to achieve ways to improve their quality of life and longevity.

PMID: 25105135

 

SUPPLEMENTS:

In the last decades the world population has continuously grow older and, as type 2 diabetes mellitus is more common at middle and older-ages, the prevalence of this disease has also increased with aging of the world population. The growing prevalence of obesity worldwide has been reported as the leading cause for the increasing prevalence of type 2 diabetes mellitus. A hallmark of human aging is the increase in adipose mass, especially of visceral adipose mass. Adipose tissue secretes several inflammatory adipokines, such as leptin, adiponectin and chemerin. Adipokines, by interfering with glucose and lipid metabolisms, with the inflammatory process and blood pressure, may predispose to cardiovascular disease events. Thus, obesity, diabetes and aging appear to be closely linked (Figure 1).

 

Figure1_WBF

Figure 1 – Aging associates with obesity and type 2 diabetes mellitus (T2DM) favoring the occurrence of cardiovascular disease (CVD) events.

 

We studied the relationship between aging and the levels of the adipokines chemerin, adiponectin and leptin, by assessing its levels in middle-age type 2 diabetes mellitus patients (38-64 years old), in old type 2 diabetes mellitus patients (with more than 65 years old) and in non-diabetic subjects, matched for age and gender.

Adiponectin plays a protective role against insulin resistance and diabetes development, has anti-inflammatory activity, and may protect against cardiovascular diseases. Leptin contributes to the obesity-related inflammation and the lack of its activity leads to insulin resistance and diabetes. Both adiponectin and leptin levels are known to be altered in obesity. Chemerin plays a crucial role in adipose tissue differentiation and development, acts as a modulator of glucose and lipid metabolic pathways; chemerin blood levels are known to be altered in obesity. In this study, we found that patients with type 2 diabetes mellitus, as compared to controls, presented lower levels of adiponectin and higher values of chemerin and leptin, which favors hyperlipidemia, inflammation and, ultimately, cardiovascular disease events.

A comprehensive understanding of the impairment in glucose homeostasis in the elderly is necessary, in order to achieve ways to improve their quality of life and longevity. According to our study, aging in type 2 diabetes mellitus patients is associated with an altered adipokine secretion, correlating positively with leptin and chemerin, and negatively with adiponectin. Our data also revealed that adiponectin and leptin levels in elderly patients with type 2 diabetes mellitus seem to be closely linked to obesity and to length of the disease. In the older group of type 2 diabetes mellitus patients, circulating chemerin concentrations are increased and seem to be independent of the length of disease and of body mass index, suggesting that adipocyte dysfunction is enhanced with aging (Figure 2). Moreover, older type 2 diabetes mellitus patients, by presenting an altered adipokine secretion, may be at a higher risk for cardiovascular disease events. These patients should be encouraged to adopt strategies to reduce the cardiovascular disease risk, by implementing healthy diet habits and physical exercise practice.

 

Figure2_WBF

Figure 2 – The relationship between type 2 diabetes mellitus (T2DM), aging, adipokine profile and cardiovascular disease (CVD) risk.

 

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