Association between fasting glucose and C-reactive protein in a Japanese population: the Minoh study

To investigate the association between fasting glucose and C-reactive protein (CRP), we examined 1715 Japanese individuals (723 men and 992 women) aged 40-69 years who did not have medication for hypertension, diabetes, or dyslipidemia, a history of cardiovascular disease or CRP levels>10mg/l. There was a statistically significant unadjusted correlation between CRP and each component of the metabolic syndrome, including fasting glucose, fasting insulin, body mass index, systolic blood pressure, diastolic blood pressure, high-density lipoprotein cholesterol (negative), and triglycerides in both men and women. With adjustment for age, cigarette smoking, alcohol intake, and other components of the metabolic syndrome, the CRP increments (as back-transformed) compared with the lowest tertile of normal fasting glucose were 0.99, 1.05, 1.21, and 1.34mg/l (P for trend=0.008) with the second lowest and highest tertiles of normal fasting glucose, impaired fasting glucose, and type-2 diabetes, respectively in men. The respective adjusted CRP increments were 1.12, 1.23, 1.33, and 1.93mg/l (P for trend<0.001) in women. In the stratified analyses of CRP levels by sex, obesity status, and fasting glucose category or the number of components of the metabolic syndrome, an increase in CRP levels was greater in women than men with obesity and higher fasting glucose category (gender interaction: P<0.001) or an increased number of components of the metabolic syndrome (gender interaction: P=0.003). These results indicate that CRP levels increase continuously across the spectrum of fasting glucose in both sexes. This association is more pronounced in women.     

Relationships between C-reactive protein, white blood cell count, and insulin resistance in a Chinese population

This study is to clarify whether C-reactive protein (CRP) and white blood cell (WBC) count influence insulin homeostasis to the same degree. Serum CRP and peripheral WBC were measured in 739 subjects with normal glucose regulation, 512 with impaired glucose regulation, and 502 newly diagnosed diabetic patients. Levels of insulin resistance (IR) were assessed using the index of homeostasis model (HOMA-IR). Serum CRP and WBC were significantly correlated with HOMA-IR and risk factors of IR. Relative risks of IR for each 1-SD increase of Ln (CRP) and Ln (WBC) were 1.28 (1.10-1.47) and 1.15 (1.01-1.31), respectively after adjustment for age, sex, obesity measurements, and other traditional risk factors. Additional adjustment for WBC slightly attenuated the association between CRP and IR [1.25 (1.08-1.45); P?=?0.003] whereas adjustment for CRP substantially attenuated the association of WBC with IR toward null (P?=?0.134). Moreover, individuals with both high levels of CRP and WBC were at higher risks of IR than those with high CRP or WBC alone. Both CRP and WBC were significantly associated with risks of IR. CRP might be a more effective biomarker in terms of the association with IR.     

C-reactive protein and insulin resistance in non-obese Japanese type 2 diabetic patients

The aim of the present study was to investigate the relationship between C-reactive protein (CRP) and insulin resistance in non-obese Japanese type 2 diabetic patients. A total of 135 non-obese Japanese type 2 diabetic patients (96 men and 39 women, aged 36 to 83 years, with a body mass index [BMI] of 16.2 to 26.8 kg/m2) were studied. BMI, glycosylated hemoglobin (HbA(1c)), fasting concentrations of plasma glucose, serum lipids (triglycerides, low-density lipoprotein [LDL] cholesterol, high-density lipoprotein [HDL] cholesterol, and total cholesterol), CRP, and fibrinogen were measured. LDL cholesterol was calculated using the Friedewald formula. Insulin resistance was estimated by the insulin resistance index of homeostasis model assessment (HOMA-IR). Univariate regression analysis showed that CRP value was positively correlated to age (r = 0.218, P =.012), BMI (r = 0.239, P =.006), HOMA-IR (r = 0.397, P <.0001), triglycerides (r= 0.310, P <.005), LDL cholesterol (r= 0.179, P =.038), and fibrinogen (r = 0.371, P <.0001) levels and inversely correlated to HDL cholesterol (r = 0.174, P =.044) level in our diabetic patients. Multiple regression analysis showed that CRP was independently predicted by HOMA-IR (P<.0001, F = 11.6) and fibrinogen (P<.0001, F = 34.2), which explained 23.5% of the variability of CRP in our non-obese Japanese type 2 diabetic patients. These results indicate that insulin resistance and fibrinogen level are independent predictors of CRP in non-obese Japanese type 2 diabetic patients.     

Association between serum ferritin and the insulin resistance syndrome in a representative population

OBJECTIVE: Unexplained hepatic iron overload with increased serum ferritin (SF) values has been associated with the insulin resistance syndrome (IRS), defined by the presence of one or more of the following criteria: increased body mass index (BMI), diabetes, hyperlipidemia or hypertension. However, as yet the association between IRS and SF in a representative population has not been investigated. METHODS: The study subjects participated in a nationwide epidemiological survey on metabolic disorders in the adult German population. The 1200 probands included in this study are representative of the German population. To eliminate major causes of secondary iron overload, 114 (9.5%) subjects with excessive alcohol consumption and 16 (1.5%) subjects with serological evidence for hepatitis B or C were excluded. For all remaining 1070 probands, complete clinical data of SF, HbA1c, known diabetes, BMI, cholesterol, high-density lipoprotein-cholesterol and blood pressure were available. RESULTS: SF values were significantly increased in men and women with high BMI (> 25 kg/m2), increased cholesterol (> 200 mg/dl), and increased systolic (> 160 mmHg) blood pressure, in women with diabetes, and in men with increased diastolic (> 95 mmHg) blood pressure. Furthermore, there was a significant correlation between the number of IRS criteria and SF. CONCLUSIONS: This study shows a significant correlation between SF and the presence of IRS criteria in a large representative population. Interestingly, the severity of the IRS seems to be associated with increased SF levels suggesting a causal connection. Further studies are required to investigate the pathophysiological mechanism and consequences of increased SF levels in patients with IRS.     

Interrelationships between inflammation, C-reactive protein, and insulin resistance

The recognition that inflammation plays a fundamental role in atherothrombosis has led to the measurement of circulating inflammatory biomarkers such as high-sensitivity C-reactive protein (hs-CRP) as a means of improving cardiovascular disease detection and prevention. Clinically, levels of hs-CRP >3 mg/L indicate elevated risk for myocardial infarction and stroke, even among apparently healthy individuals with low-to-normal lipid levels. Emerging laboratory and epidemiologic data now link inflammation and hs-CRP to insulin resistance in that hs-CRP levels have been associated with impaired insulin sensitivity and the development of dysglycemic conditions, including the cardiometabolic syndrome and incident type 2 diabetes. hs-CRP has also been associated with each of the individual components of the cardiometabolic syndrome. Furthermore, in large prospective studies, hs-CRP adds prognostic information about cardiovascular risk beyond that provided by the cardiometabolic syndrome. These findings have led to discussion about the addition of hs-CRP measurement to the current definition of the cardiometabolic syndrome to improve detection of risk for both diabetes and cardiovascular events in patients. Multiple clinical studies are now underway that are evaluating whether agents traditionally used to improve glycemic control may also significantly reduce hs-CRP.     

Association between insulin resistance and metabolic syndrome risk factors in Japanese

Aims/Introduction: It is important to identify individuals at risk of metabolic syndrome (MetS), namely those with insulin resistance. Therefore, the aim of the present study was to find anthropometric and metabolic parameters that can better predict insulin resistance. Subjects and Methods: We selected 3899 individuals (2058 men and 1841 women), excluding those with fasting plasma glucose (FPG) ≥126 mg/dL, on medication for hypertension, dyslipidemia or diabetes, and those with a history of advanced macrovascular disease. Using multivariate analyses, we selected components for obesity, lipids, and blood pressure based on the strength of their association with the homeostasis model assessment of insulin resistance (HOMA‐IR). Results: In multiple linear regression analysis, body mass index (BMI), waist circumference (WC), triglycerides (TG), high‐density lipoprotein–cholesterol (HDL‐C), and systolic blood pressure (SBP) were selected in men and women, and the effect of BMI on HOMA‐IR outweighed that of WC. In multiple logistic regression analysis, BMI, TG, and SBP were significantly associated with HOMA‐IR ≥2.5 in both genders, but WC and HDL‐C were only selected in men. Combinations of BMI, TG, SBP, and FPG showed higher HOMA‐IR values than those of the existing MetS components, considered useful for the identification of individual with higher insulin resistance. Conclusions: Body mass index, TG and SBP were selected as components significantly related to insulin resistance. The selected components were fundamentally adherent to the existing MetS criteria, the only difference being the measure of obesity, in which a stronger association with insulin resistance was observed for BMI than WC. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2011.00162.x, 2011)     

Brachial-ankle pulse wave velocity and metabolic syndrome in a Japanese population: the Minoh study.

To investigate the association between brachial-ankle pulse wave velocity (baPWV) and metabolic syndrome (MS), we examined 374 men and 622 women aged 40 to 69 years who did not have a past history of either coronary heart disease or stroke. We used a modified National Cholesterol Education Program definition of MS that utilizes body mass index instead of waist circumference. Age-adjusted mean values of baPWV were greater when obesity, high systolic and diastolic blood pressures, high triglyceride level, low high-density lipoprotein cholesterol, high fasting glucose level or MS itself were present. baPWV was also associated with fasting insulin levels and homeostasis model assessment of insulin resistance (HOMA-IR) values. Mean values of baPWV (adjusted for age, smoking status, and drinking status) in men with 0, 1, 2, and > or =3 features of MS were 1,409, 1,517, 1,640, and 1,665 cm/s, respectively (p for trend <0.001). The respective adjusted mean baPWV values for women were 1,368, 1,531, 1,547, and 1,661 cm/s (p for trend <0.001). As for insulin resistance, the adjusted mean baPWV values across quartiles of HOMA-IR (lowest to highest) were 1,488, 1,514, 1,566, and 1,624 cm/s (p for trend <0.001) for men. The respective adjusted mean baPWV values for women were 1,395, 1,441, 1,464, and 1,539 cm/s (p for trend <0.001). Our findings indicate that clustered features of MS and insulin resistance are strongly associated with the risk for increased baPWV in Japanese men and women.     

Association study between C-reactive protein genes and ischemic stroke in Japanese subjects

BACKGROUND: C-reactive protein (CRP) is reported to be involved in the development of atherosclerosis. Elevated CRP levels are considered to be a predictor of ischemic stroke (IS) in elderly individuals. Some single-nucleotide polymorphisms (SNP) are reportedly associated with elevated CRP levels. The aims of this study were to genotype some of the SNP in the human CRP gene and to assess the association between the CRP gene and IS. METHODS: Japanese patients with IS (72.4 +/- 8.2 years of age, n = 152) and elderly Japanese subjects without IS (78.0 +/- 4.2 years of age, n = 304) were genotyped for four SNP of the human CRP gene: rs1341665, rs1800947, rs1130864, and rs1205. Each genotyping was performed using the TaqMan SNP genotyping assay. The haplotype-based association study was assessed with a permutation test. RESULTS: The genotype rs1800947 was statistically significant between patients with IS and control subjects (CC+GC versus GG variant, P = .016 by multiple logistic regression analysis). This analysis revealed that the CC+GC variant of rs1800947 was an independent risk factor of IS. All four SNP were located in one haplotype block. The haplotype was constructed using rs1341665, rs1800947, and rs1130864, in that order. There was a significant association between IS and the C-C-C haplotype (P = .015). CONCLUSIONS: The rs1800947 SNP and the C-C-C haplotype in the CRP gene appear to be prognostic markers of ischemic stroke and this polymorphism could be a useful genetic marker.     

C反应蛋白在胰岛素抵抗中的作用及意义

慢性亚临床炎性反应在糖尿病和胰岛素抵抗的发生和发展中起重要的作用.C反应蛋白(CRP)是一个系统的炎性反应标志物.大量的证据表明CRP水平与糖代谢密切相关.在胰岛素抵抗者中,体内CRP水平的高低,可预测其以后并发心血管事件的危险性.     

非糖尿病人群中补体C3、超敏C反应蛋白与胰岛素抵抗指数(HOMA2-IR)相关性分析

目的 观察非糖尿病人群血清补体C3、超敏C反应蛋白(hs-CRP)水平及其与胰岛素抵抗的关系.方法 纳入587例非糖尿病个体,测定体重、身高、血压、腰围、空腹血浆葡萄糖、血清胰岛素、血脂、补体C3及hs-CRP等,计算胰岛素抵抗指数(HOMA2-IR).以HOMA2-IR上四分位为切点划分胰岛素抵抗与非胰岛素抵抗.结果 胰岛素抵抗人群补体C3和hs-CRP显著高于非胰岛素抵抗人群.校正性别、年龄、BMI及腰围后,部分相关分析发现补体C3与HOMA2-IR显著正相关(r=0.19,P＜0.01).去除性别、年龄、收缩压、舒张压、总胆固醇、甘油三酯、高密度脂蛋白胆固醇和腰围的影响后,随着补体C3的升高发生胰岛素抵抗的危险增加3.78倍(OR=3.78,P＜0.05);而hs-CRP与胰岛素抵抗的发生无统计学意义.结论 在非糖尿病人群中,补体C3与胰岛素抵抗的相关性强于hs-CRP.

Abstract：

Objective To observe and compare the association of serum levels of of complement component 3(C3)and high-sensitive C-reactive protein(hs-CRP)with insulin resistance in non-diabetic subjects. Methods 587non-diabetic Chinese were recruited. Weight, height, blood pressure, waist circumference, fasting plasma glucose,fasting serum insulin, blood lipids, C3 and hs-CRP were measured. HOMA index(HOMA2-IR)was calculated.Insulin resistance was defined as the upper quartile of HOMA2-IR. Results C3 and hs-CRP were significantly higher in subjects with insulin resistance compared with subjects without insulin resistance. After controlling for age, gender,body mass index, and waist circumference, C3 was positively and significantly correlated with HOMA2-IR(r = 0.19,P＜0.01). As C3 increased, subjects were 3.78(OR= 3.78, P＜0.05)times more likely to suffer from insulin resistance, after adjustment for age, gender, systolic blood pressure, diastolic blood pressure, total cholesterol,triglycerides,high-density lipoprotein cholesterol, and waist circumference. However, hs-CRP was not significantly correlated with insulin resistance. Conclusions Serum complement component 3 has a more marked association with insulin resistance than hs-CRP in non-diabetic Chinese.     

Association between insulin, insulin resistance, and gallstone disease in Korean general population]

BACKGROUND/AIMS: Diabetes is one of the risk factors of gallstone diseases. Many studies found a positive association between insulin and gallstones in individuals with diabetes. However, this association is unclear in non-diabetes. So we conducted a case-control study for the evaluation of the association between gallstone diseases and fasting serum insulin level, insulin resistance in non-diabetic Korean general population. METHODS: This study was a prospective case-control study on 118 Korean subjects which included clinical examination, abdominal ultrasound, and blood chemistries. Serum fasting insulin level were determined by radioimmunoassay and concentrations of cholesterol, glucose, and triglycerides by standard enzymatic colorimetric methods. Insulin resistance was determined by the homeostasis model assessment (HOMA-IR). Body mass index (BMI), percentage of body fat, and waist hip ratio were also measured. RESULTS: We studied 118 subjects with no clinical evidence of diabetes mellitus and serum glucose <126 mg/dL. Compared with controls (n=89), cases (n=29) had higher levels of serum insulin, glucose, triglyceride levels, and BMI. In t-test and chi-square test for variables, the association between gallstone disease and serum insulin, HOMA-IR index, and BMI were statistically significant (p<0.05). In multiple logistic regression analysis, gallstone disease risk increased with the level of serum insulin (p=0.024, odds ratio=1.376) and HOMA-IR index (p=0.013, odds ratio=2.006). CONCLUSIONS: We suggest that hyperinsulinemia and insulin resistance could be associated with gallstone formation in individuals without clinical diagnosis of diabetes mellitus and with normal serum glucose level.     

Association between serum C-reactive protein levels and pulse wave velocity: a population-based cross-sectional study in a general population

Arterial stiffness as determined by aortic pulse wave velocity (PWV) has been shown to predict cardiovascular events in high-risk subjects such as those with hypertension or end-stage renal disease. Although it is suspected that low-grade inflammation as represented by increased C-reactive protein (CRP) plays an important role in the progression of atherosclerosis, it is not yet known whether serum CRP levels are associated with PWV. To examine the relationship between brachial-ankle PWV (baPWV) and serum CRP levels, several cardiovascular risk factors including these two markers (baPWV and CRP) were measured in 870 participants (mean age 59 years) randomly selected from a general population. Age, male gender, systolic blood pressure, heart rate, diabetes, and serum CRP levels increased with the quartiles divided by baPWV (all, p<0.01). By multiple regression analysis, age (p<0.001), systolic blood pressure (p<0.001), heart rate (p<0.001), body mass index (p<0.001), and CRP (p<0.01) were significant and independent predictors for baPWV. In conclusion, this cross sectional study has demonstrated in the general population that the arterial stiffness marker baPWV was independently correlated with serum CRP levels after adjustment for other established cardiovascular risks factors. This result suggests that baPWV may be a surrogate marker for atherosclerotic vascular damages including an inflammatory component.     

Association between components of the metabolic syndrome and serum levels of C-reactive protein in Japanese workingmen

Middle-aged workingmen (N=984) with no present medical treatment were enrolled to determine whether there is an association between the metabolic syndrome (MetS) and serum levels of C-reactive protein. MetS was defined as follows: waist circumference > or = 85 cm as a necessary criterion; in addition, two or more of the following criteria were required: serum triglycerides > or = 150 mg/dL and/or highdensity lipoprotein cholesterol <40 mg/dL; systolic blood pressure > or = 130 mm Hg and/or diastolic blood pressure > or = 85 mm Hg; fasting blood glucose > or = 110 mg/dL. Three groups were identified by the components of MetS: a reference group of subjects with a waist circumference <85 cm; group A, with a waist circumference > or = 85 cm with no or one additional MetS criterion; and group B, subjects satisfying the criteria for a diagnosis of MetS. Logistic regression analysis revealed that the components of MetS contributed significantly to serum levels of C-reactive protein. The odds ratios were 2.5 (group A) and 4.0 (group B), when 3 mg/L was adopted as the cutoff value of C-reactive protein.     

Association between high-sensitivity C-reactive protein and hyperuricemia

The aim of the study was to examine the cross-sectional association between high-sensitivity C-reactive protein (hsCRP) and hyperuricemia (HU). The hsCRP was measured by latex turbidity method. Uric acid was detected on Beckman Coulter AU 5800. HU was defined as uric acid ≥416 μmol/L for the male population and ≥360 μmol/L for the female population. A multivariable logistic analysis model was applied to test the association after adjusting for a number of potential confounding factors. A total of 1935 subjects were included in this study. According to the multivariable regression model, the relative odds of the prevalence of HU were increased by 0.56 times in the third quintile (OR 1.56, 95 % CI 1.03–2.38, P = 0.04), 0.55 times in the fourth quintile (OR 1.55, 95 % CI 1.01–2.36, P = 0.04) and 0.96 times in the fifth quintile (OR 1.96, 95 % CI 1.29–2.98, P < 0.01) of hsCRP comparing with the lowest quintile, and P for trend was smaller than 0.01. In the male population, a positive association existed in the highest quintile of hsCRP (OR 1.66, 95 % CI 1.04–2.66, P = 0.04), and P for trend was 0.07. In the female population, the multivariable-adjusted ORs (95 % CI) of HU in the fourth and fifth quintile of hsCRP were 3.02 (95 % CI 1.09–8.35, P = 0.03) and 3.66 (95 % CI 1.36–9.89, P = 0.01), respectively, and P for trend was smaller than 0.01. The findings of this cross-sectional study suggest that the hsCRP level is positively associated with the prevalence of HU. Level of evidence Cross-sectional study, Level III.     

Association between serum gamma-glutamyltransferase and C-reactive protein

A series of epidemiological studies have suggested serum gamma glutamyltransferase (GGT) within its normal range might be an early marker of oxidative stress. Oxidative stress appears to be a key component of many reactions associated with chronic inflammation. Therefore, we examined the cross-sectional association between deciles of serum GGT and concentrations of serum C-reactive protein (CRP), a marker of chronic inflammation, among 12,110 adult participants in the third U.S. National Health and Nutrition Examination Survey. After adjustment for race, sex, age, cigarette smoking, alcohol intake, and body mass index (BMI), serum concentration of GGT across all deciles was positively associated with serum concentrations of CRP (P for trend<0.01). For example, adjusted relative risks of serum CRP> or =3.0mg/L by deciles of serum GGT were 1.0, 1.23, 1.40, 1.59, 1.62, 1.61, 2.17, 2.38, 2.45, and 3.41 (P for trend<0.01). This association was consistently observed among all subgroups; Non-Hispanic White, Non-Hispanic Black, Mexican American, men, women, non-drinkers, drinkers, non-smokers, ex-smokers, current smokers, BMI<25, BMI 25-29.9, and BMI> or =30. The strong association of serum GGT and CRP suggest that further studies on cellular and/or serum GGT might help to elucidate the association between oxidative stress and inflammation.     

妊娠糖尿病患者胰岛素抵抗与血清C反应蛋白水平的相关性研究

目的:研究妊娠糖尿病(GDM)患者与正常妊娠妇女胎盘激素、超敏C反应蛋白(hs-CRP)与妊娠胰岛素抵抗和胰岛β细胞分泌功能的关系,分析发生GDM的危险因素,探讨GDM的发病机制.方法:GDM孕妇和正常孕妇各50例,均测胎盘激素、hs-CRP、血糖及胰岛素水平.结果:GDM组的hs-CRP水平明显高于正常对照组(P＜0.05).2组的胎盘激素水平(雌激素、孕激素、泌乳素)无统计学意义.GDM组的早期相胰岛β细胞分泌功能(△I30/△G30)明显低于对照组,P＜0.001.hs-CRP与孕前体重、孕前体重指数(BMI)、空腹胰岛素、稳态模式评估法胰岛素抵抗指数(HOMA-IR)呈正相关(r=0.287、0.289、0.248、0.299,P＜0.01),与△I30/△G30呈负相关(r=-0.509,P＜0.001).在纠正了孕前体重、孕前BMI、糖筛查时的体重和BMI后,hs-CRP与空腹胰岛素、HOMA-IR不再相关(P＞0.05).结论:炎症反应参与并加重妊娠胰岛素抵抗;GDM孕妇存在早期相胰岛β细胞分泌缺陷.     

C-reactive protein concentration is more strongly related to metabolic syndrome in women than in men: the Minoh Study.

BACKGROUND: The gender differences in the association between C-reactive protein (CRP) and features of the metabolic syndrome (MS) need to be elucidated among Japanese. METHODS AND RESULTS: The study population included 715 men and 988 women aged 40-69 years who were not taking anti-hypertensive, lipid-lowering, hypoglycemic, anti-thrombotic, or non-steroidal anti-inflammation medications, and did not have a past history of cardiovascular disease or CRP concentration >10 mg/L. Except for high-density lipoprotein cholesterol, the unadjusted correlation between CRP and each MS component, including body mass index (BMI), systolic and diastolic blood pressures, triglycerides, fasting glucose, fasting insulin, and uric acid, was greater in women than in men. With adjustment for age, smoking status, and drinking status, the differences in CRP concentrations between those with the MS components of BMI, triglycerides, and uric acid and those without were greater in women than in men. Results of stratified analyses by the number of components of the MS of 0, 1, 2, 3, and > or = 4 revealed that an increase in CRP concentrations was greater in women than men with an increased number of components of the MS (gender interaction, p = 0.005). This tendency was observed in non-smokers, but not in current smokers (gender interaction, p = 0.013 and = 0.513, respectively). CONCLUSIONS: CRP concentrations are closely related to the MS-like state in both sexes, but an increase in CRP concentration associated with risk factor-clustering is more pronounced in women, particularly non-smokers.     

Adiponectin, an adipocyte-derived protein, predicts future insulin resistance: two-year follow-up study in Japanese population

It has been reported that the serum adiponectin level was negatively correlated with body mass index (BMI), insulin resistance index, and triglycerides and was positively correlated with high-density lipoprotein cholesterol in several cross-sectional studies. However, the causal relationship has not been elucidated. We investigated whether the baseline adiponectin level could predict subsequent changes in insulin resistance, lipid profile, or body weight in a 2-yr longitudinal study. This study included 590 male Japanese subjects, aged 30-65 yr, who received annual health checkups in both 2000 and 2002. Blood pressure, heart rate, and anthropometric and metabolic parameters, including serum insulin and adiponectin levels, were determined. The insulin resistance index was calculated based on homeostasis model assessment. Baseline adiponectin level was not correlated with the subsequent change in lipid profile or BMI in 2 yr after adjustment for each baseline value. However, the baseline adiponectin level was negatively correlated with subsequent changes in insulin and insulin resistance index based on homeostasis model assessment, even after adjustment for change in BMI (r = -0.162 and r = -0.140, respectively). These findings suggest that the serum adiponectin concentration predicts subsequent changes in insulin resistance, but not in lipid profile or body weight.