Objective: To study serum adiponectin level in relation to body fat distribution and tissue insulin sensitivity by using the extended hyperinsulinemic euglycemic clamp technique.
Methods: Extended hyperinsulinemic euglycemic clamp was performed in 44 Chinese individuals with normal glucose tolerance from Shanghai area, including 12 subjects with normal weight [body mass index (BMI) < 25 kg/m(2)], 19 with overweight (25 kg/m(2) < or = BMI < 30 kg/m(2)), and 13 with obesity (BMI > or = 30 kg/m(2)). The rate of insulin-mediated glucose disposal (Rd) during the steady state of glucose clamp was used to assess the peripheral tissue insulin sensitivity. Total body fat depots [BMI, percentage of body fat (FAT%), and body fat mass (FM)], regional body fat depots [waist circumference (W), hip circumference (H), W and H ratio (WHR), abdominal subcutaneous fat area (SA), intra-abdominal fat area (VA), and femoral subcutaneous fat area (FA)] were measured on all subjects. Fasting serum adiponectin level was determined by radioimmunoassay.
Results: (1) After the adjustment for age and sex, the serum adiponectin concentrations in the overweight and obesity groups were (8.7 +/- 4.8) mg/L and (6.7 +/- 0.8) mg/L, both significantly lower than that in the normal weight group [(15.7 +/- 1.8) mg/L, both P < 0.01]. (2) Serum adiponectin concentration was negatively correlated with BMI, W, WHR, FAT%, FM and VA, especially with W and VA (r = -0.46, P < 0.01, and r = -0.53, P < 0.01). (3) Serum adiponectin concentration was positively correlated with Rd (r = 0.52, P < 0.01) and the rate of glycogen synthesis (r = 0.36, P < 0.05), and was negatively correlated with free fatty acid level (r = -0.41, P < 0.05). (4) Stepwise regression analysis indicated that in addition to sex, BMI, WHR or VA and SA, serum adiponectin level was also the independent contributing factor for Rd, which explains 3.52% and 4.84% of the variance respectively (P all < 0.05).
Conclusion: (1) The decrease in serum adiponectin level is associated with the increase of total body fat depot, especially the increase of total body fat depot in intra-abdominal fat area. (2) Serum adiponectin level is an independent contributing factor for insulin sensitivity.