糖尿病における尿中アディポネクチンの早期腎障害指標に関する研究

概要

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For noninvasive evaluation of diabetes risk by measuring urine or saliva, we developed an ultra-sensitive assay for adiponectin which is secreted by adipocytes and is strongly associated with insulin resistance.The ultra-sensitive assay primarily measures middle- and high-molecular-weight adiponectin. Measurements of the blood and urinary concentrations of adiponectin in patients with diabetes, obese subjects without diabetes and healthy subjects revealed that the urinary concentration of adiponectin did not reflect adiponectin levels in blood, unlike leptin, resistin and insulin. On the other hand, urinary adiponectin showed a strong correlation with urinary albumin. Notably, the urinary adiponectin level was high in some subjects in which microalbuminuria was not detected. Therefore, we examined the utility of urinary adiponectin as an early diabetic nephropathy index. Results showed that blood contains middle- or high-molecular-weight adiponectin, while low-molecular-weight adiponectin (trimers) is found in urine. In subjects with a low estimated glomerular filtration rate (eGFR), the urinary/blood adiponectin ratio was found to be ten times higher than that of a person. Furthermore, ROC analysis showed that the urinary adiponectin levels were significantly higher in patients with diabetes compared with urinary insulin and urinary resistin levels. In conclusion, urinary adiponectin may be useful as a new early diabetic nephropathy index.