Title:Molecular Mechanisms of Diabetes and Atherosclerosis: Role of Adiponectin
Volume: 12
Issue: 2
Author(s): Ken Kishida, Tohru Funahashi and Iichiro Shimomura
Affiliation:
Keywords:
Adipocytokines, adiponectin, atherosclerosis, diabetes, sleep-disordered breathing, visceral fat
Abstract: Type 2 diabetes mellitus (T2DM) is a disease characterized by inadequate beta-cell response due to progressive
insulin resistance that typically accompanies physical inactivity and weight gain. T2DM is associated with substantial
morbidity and mortality related to the associated atherosclerotic cardiovascular risks and diabetic vasculopathies,
including microangiopathies (e.g., blindness and renal failure) and macroangiopathies (atherosclerosis). The increasing
global prevalence of T2DM is linked to the rising rates of obesity, especially abdominal obesity. Visceral fat accumulation
is upstream of obesity-related disorders including atherosclerotic cardiovascular disease (ACVD), and is associated
with impaired insulin sensitivity and atherosclerosis through dysregulated production of adipocytokines, especially
hypoadiponectinemia. This review article discusses the pathophysiological mechanisms responsible for T2DM and
atherosclerosis, focusing on adiponectin. Clinical and experimental studies have shown that hypoadiponectinemia
contributes to a variety of life style-related diseases including T2DM and atherosclerosis. It is likely that life-style
modification, visceral fat reduction and use of medications that increase serum adiponectin levels (e.g., rimonabant,
thiazolidinediones, fibrates, angiotensin receptor blocker and mineralocorticoid receptor blockade) when provided in
combination can improve hypoadiponectinemia and thus prevent the development of life style-related diseases including
T2DM and ACVD.
