Serum adiponectin concentration is a positive predictor of all-cause and cardiovascular mortality in type 1 diabetes

Forsblom C, Thomas MC, Moran J, Saraheimo M, Thorn L, Waden J, Gordin D, Frystyk J, Flyvbjerg A, Groop P-H, on behalf of the FinnDiane Study Group (Folkhalsan Institute of Genetics, Helsinki; Department of Medicine Helsinki University Central Hospital, Helsinki, Finland; The Baker IDI Heart and Diabetes Institute, Melbourne, Vic.; The Queen Elizabeth Hospital, Woodville, SA, Australia; and Aarhus University Hospital, Aarhus C., Denmark). Serum adiponectin concentration is a positive predictor of all-cause and cardiovascular mortality in type 1 diabetes. J Intern Med 2011; 270: 346–355. Background. Adiponectin is widely regarded as an anti-atherogenic, antioxidant and anti-inflammatory molecule. However, adiponectin concentration is paradoxically increased in individuals with type 1 diabetes, in whom it is positively associated with adverse clinical outcomes. Objective. To explore the association between serum adiponectin concentration and mortality outcomes in adults with type 1 diabetes. Design. Multicentre prospective cohort study. Setting. Primary and tertiary care. Subjects. Finnish adults with type 1 diabetes (n = 2034). Main outcome measures. All-cause and cardiovascular mortality. Independent predictors of mortality were determined using the Cox and the Fine and Gray competing risks proportional hazards models. Results. During a median of 11 years of follow-up, there were 173 deaths (8.5%, 1.0 per hundred person-years). Adiponectin was linearly associated with all-cause mortality [Cox model: hazard ratio (HR) 1.02, 95% confidence interval (CI) 1.01–1.03, P