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Mutual effect modification between adiponectin and HDL as risk factors of cardiovascular events in Type 2 diabetes individuals: a cohort study

  • Nephrology - Original Paper
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Abstract

Purpose

We aimed to assess whether high-density lipoprotein (HDL) cholesterol modifies the association between adiponectin and incident cardiovascular (CV) morbidity and mortality in Type 2 Diabetes Mellitus (T2DM) and vice versa.

Methods

At baseline, 106 T2DM participants with various degrees of renal function were enrolled and followed up over a period of 7 years with fatal/nonfatal CV events as outcome.

Results

During the follow-up, 49 participants experienced incident CV events (28 fatal, 21 nonfatal). On univariate Fine and Gray sub-hazard models, HDL cholesterol was a strong modifier of the association between adiponectin and CV outcomes both on crude (P = 0.011) and gender- and eGFR-adjusted models (P = 0.010). The protective effect for CV events portended by a fixed increase in adiponectin (1 μg/ml) was progressively higher across increasing values of HDL cholesterol. Moreover, plasma adiponectin also modified the protective effect of HDL on CV outcomes both in crude and multivariate analyses. We found a mutual effect modification between adiponectin and HDL as risk factors of CV events in participants with T2DM.

Conclusion

Our results are coherent with the hypothesis that HDL cholesterol might play a pivotal role in the interpretation of the association between adiponectin and the risk of adverse CV outcomes in this population.

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Funding

This research received no external funding.

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Authors and Affiliations

  1. Division of Nephrology and Hypertension, First Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636, Thessaloniki, Greece

    Stefanos Roumeliotis, Vassilios Liakopoulos & Athanasios Roumeliotis

  2. Department of Microbiology, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636, Thessaloniki, Greece

    Aikaterini Stamou

  3. Department of Nephrology, School of Medicine, Democritus University of Thrace, 68100, Alexandroupolis, Greece

    Stylianos Panagoutsos

  4. Institute of Clinical Physiology (IFC-CNR), Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, 89127, Reggio Calabria, Italy

    Stefanos Roumeliotis, Graziella D’Arrigo & Giovanni Tripepi

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  1. Stefanos Roumeliotis
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  2. Vassilios Liakopoulos
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  3. Athanasios Roumeliotis
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  4. Aikaterini Stamou
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  6. Graziella D’Arrigo
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Contributions

Conceptualization: S.R. and V.L.; methodology: A.S.; statistical analysis: S.R. and G.T.; investigation: A.R.; patient recruiting: A.R. and S.P.; writing—original draft preparation: S.R. and A.S.; writing—review and editing: G.T., G.D’A. and V.L.; supervision: S.P. and V.L. All the authors have read and agreed to the published version of the manuscript.

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Correspondence to Vassilios Liakopoulos.

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Roumeliotis, S., Liakopoulos, V., Roumeliotis, A. et al. Mutual effect modification between adiponectin and HDL as risk factors of cardiovascular events in Type 2 diabetes individuals: a cohort study. Int Urol Nephrol 53, 2583–2591 (2021). https://doi.org/10.1007/s11255-021-02828-4

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