TY - JOUR A1 - Jannasch, Franziska A1 - Kröger, Janine A1 - Agnoli, Claudia A1 - Barricarte, Aurelio A1 - Boeing, Heiner A1 - Cayssials, Valérie A1 - Colorado-Yohar, Sandra A1 - Dahm, Christina C. A1 - Dow, Courtney A1 - Fagherazzi, Guy A1 - Franks, Paul W. A1 - Freisling, Heinz A1 - Gunter, Marc J. A1 - Kerrison, Nicola D. A1 - Key, Timothy J. A1 - Khaw, Kay-Tee A1 - Kühn, Tilman A1 - Kyro, Cecilie A1 - Mancini, Francesca Romana A1 - Mokoroa, Olatz A1 - Nilsson, Peter A1 - Overvad, Kim A1 - Palli, Domenico A1 - Panico, Salvatore A1 - Quiros Garcia, Jose Ramon A1 - Rolandsson, Olov A1 - Sacerdote, Carlotta A1 - Sanchez, Maria-Jose A1 - Sahrai, Mohammad Sediq A1 - Schübel, Ruth A1 - Sluijs, Ivonne A1 - Spijkerman, Annemieke M. W. A1 - Tjonneland, Anne A1 - Tong, Tammy Y. N. A1 - Tumino, Rosario A1 - Riboli, Elio A1 - Langenberg, Claudia A1 - Sharp, Stephen J. A1 - Forouhi, Nita G. A1 - Schulze, Matthias Bernd A1 - Wareham, Nicholas J. T1 - Generalizability of a Diabetes-Associated Country-Specific Exploratory Dietary Pattern Is Feasible Across European Populations JF - The Journal of Nutrition N2 - Background: Population-specificity of exploratory dietary patterns limits their generalizability in investigations with type 2 diabetes incidence. Objective: The aim of this study was to derive country-specific exploratory dietary patterns, investigate their association with type 2 diabetes incidence, and replicate diabetes-associated dietary patterns in other countries. Methods: Dietary intake data were used, assessed by country-specific questionnaires at baseline of 11,183 incident diabetes cases and 14,694 subcohort members (mean age 52.9 y) from 8 countries, nested within the European Prospective Investigation into Cancer and Nutrition study (mean follow-up time 6.9 y). Exploratory dietary patterns were derived by principal component analysis. HRs for incident type 2 diabetes were calculated by Prentice-weighted Cox proportional hazard regression models. Diabetes-associated dietary patterns were simplified or replicated to be applicable in other countries. A meta-analysis across all countries evaluated the generalizability of the diabetes-association. Results: Two dietary patterns per country/UK-center, of which overall 3 dietary patterns were diabetes-associated, were identified. A risk-lowering French dietary pattern was not confirmed across other countries: pooled HRFrance per 1 SD: 1.00; 95% CI: 0.90, 1.10. Risk-increasing dietary patterns, derived in Spain and UK-Norfolk, were confirmed, but only the latter statistically significantly: HRSpain: 1.09; 95% CI: 0.97, 1.22 and HRUK-Norfolk: 1.12; 95% CI: 1.04, 1.20. Respectively, this dietary pattern was characterized by relatively high intakes of potatoes, processed meat, vegetable oils, sugar, cake and cookies, and tea. Conclusions: Only few country/center-specific dietary patterns (3 of 18) were statistically significantly associated with diabetes incidence in this multicountry European study population. One pattern, whose association with diabetes was confirmed across other countries, showed overlaps in the food groups potatoes and processed meat with identified diabetes-associated dietary patterns from other studies. The study demonstrates that replication of associations of exploratory patterns with health outcomes is feasible and a necessary step to overcome population-specificity in associations from such analyses. KW - dietary patterns KW - principal component analysis KW - diet-disease association KW - type 2 diabetes mellitus KW - replication KW - meta-analysis Y1 - 2019 U6 - https://doi.org/10.1093/jn/nxz031 SN - 0022-3166 SN - 1541-6100 VL - 149 IS - 6 SP - 1047 EP - 1055 PB - Oxford Univ. Press CY - Oxford ER - TY - JOUR A1 - Japtok, Lukasz A1 - Schmitz, Elisabeth I. A1 - Fayyaz, Susann A1 - Krämer, Stephanie A1 - Hsu, Leigh J. A1 - Kleuser, Burkhard T1 - Sphingosine 1-phosphate counteracts insulin signaling in pancreatic beta-cells via the sphingosine 1-phosphate receptor subtype 2 JF - The FASEB journal : the official journal of the Federation of American Societies for Experimental Biology N2 - Glucolipotoxic stress has been identified as a key player in the progression of pancreatic beta-cell dysfunction contributing to insulin resistance and the development of type 2 diabetes mellitus (T2D). It has been suggested that bioactive lipid intermediates, formed under lipotoxic conditions, are involved in these processes. Here, we show that sphingosine 1-phosphate (S1P) levels are not only increased in palmitate-stimulated pancreatic beta-cells but also regulate beta-cell homeostasis in a divergent manner. Although S1P possesses a prosurvival effect in beta-cells, an enhanced level of the sphingolipid antagonizes insulin-mediated cell growth and survival via the sphingosine 1-phosphate receptor subtype 2 (S1P(2)) followed by an inhibition of Akt-signaling. In an attempt to investigate the role of the S1P/S1P(2) axis in vivo, the New Zealand obese (NZO) diabetic mouse model, characterized by beta-cell loss under high-fat diet (HFD) conditions, was used. The occurrence of T2D was accompanied by an increase of plasma S1P levels. To examine whether S1P contributes to the morphologic changes of islets via S1P(2), the receptor antagonist JTE-013 was administered. Most interestingly, JTE-013 rescued beta-cell damage clearly indicating an important role of the S1P(2) in beta-cell homeostasis. Therefore, the present study provides a new therapeutic strategy to diminish beta-cell dysfunction and the development of T2D. KW - type 2 diabetes mellitus KW - sphingolipids KW - survival KW - proliferation KW - Akt signaling Y1 - 2015 U6 - https://doi.org/10.1096/fj.14-263194 SN - 0892-6638 SN - 1530-6860 VL - 29 IS - 8 SP - 3357 EP - 3369 PB - Federation of American Societies for Experimental Biology CY - Bethesda ER - TY - JOUR A1 - Moehlig, M. A1 - Floeter, A. A1 - Spranger, Joachim A1 - Weickert, Martin O. A1 - Schill, T. A1 - Schloesser, H. W. A1 - Brabant, G. A1 - Pfeiffer, Andreas F. H. A1 - Selbig, Joachim A1 - Schoefl, C. T1 - Predicting impaired glucose metabolism in women with polycystic ovary syndrome by decision tree modelling JF - Diabetologia : journal of the European Association for the Study of Diabetes (EASD) N2 - Aims/hypothesis Polycystic ovary syndrome (PCOS) is a risk factor of type 2 diabetes. Screening for impaired glucose metabolism (IGM) with an OGTT has been recommended, but this is relatively time-consuming and inconvenient. Thus, a strategy that could minimise the need for an OGTT would be beneficial. Materials and methods Consecutive PCOS patients (n=118) with fasting glucose < 6.1 mmol/l were included in the study. Parameters derived from medical history, clinical examination and fasting blood samples were assessed by decision tree modelling for their ability to discriminate women with IGM (2-h OGTT value >= 7.8 mmol/l) from those with NGT. Results According to the OGTT results, 93 PCOS women had NGT and 25 had IGM. The best decision tree consisted of HOMA-IR, the proinsulin:insulin ratio, proinsulin, 17-OH progesterone and the ratio of luteinising hormone:follicle-stimulating hormone. This tree identified 69 women with NGT. The remaining 49 women included all women with IGM (100% sensitivity, 74% specificity to detect IGM). Pruning this tree to three levels still identified 53 women with NGT (100% sensitivity, 57% specificity to detect IGM). Restricting the data matrix used for tree modelling to medical history and clinical parameters produced a tree using BMI, waist circumference and WHR. Pruning this tree to two levels separated 27 women with NGT (100% sensitivity, 29% specificity to detect IGM). The validity of both trees was tested by a leave-10%-out cross-validation. Conclusions/interpretation Decision trees are useful tools for separating PCOS women with NGT from those with IGM. They can be used for stratifying the metabolic screening of PCOS women, whereby the number of OGTTs can be markedly reduced. KW - decision tree KW - HOMA KW - impaired glucose tolerance KW - insulin KW - insulin resistance KW - polycystic ovary syndrome KW - proinsulin KW - type 2 diabetes mellitus Y1 - 2006 U6 - https://doi.org/10.1007/s00125-006-0395-0 SN - 0012-186X VL - 49 SP - 2572 EP - 2579 PB - Springer CY - Berlin ER - TY - JOUR A1 - Thawnashom, Kittisak A1 - Tungtrongchitr, Rungsunn A1 - Chanchay, Siriporn A1 - Tungtrongchitr, Anchalee A1 - Raila, Jens A1 - Henze, Andrea A1 - Schweigert, Florian J. T1 - Association between Retinol-Binding protein and renal function among Asian subjects with type 2 diabetes mellitus a cross-sectionaö study JF - The Southeast Asian journal of tropical medicine and public health : official publication of the SEAMEO Regional Tropical Medicine and Public Health Project (TROPMED) N2 - Retinol-binding protein 4 (RBP4) has been suggested as new adipokine, possibly linking obesity to type 2 diabetes mellitus (T2DM). Since the kidneys are the main site of RBP4 degradation and since renal failure is a frequent co-morbid condition with diabetes mellitus, we evaluated the association among RBP4, renal function and T2DM in an Asian population. RBP4 serum levels were analyzed in 110 subjects (50 with T2DM) using an enzyme-linked immunosorbent assay (ELISA). Based on a cut-off estimated glomerular filtration rate (eGFR) of 60 ml/min per 1.73 m(2) (calculated according the abbreviated MDRD formula which uses serum creatinine level, age and gender) and on the T2DM status, subjects were assigned to four subgroups: Group A - controls with an eGFR > 60 ml/min per 1.73 m(2), Group B - controls with an eGFR < 60 ml/min per 1.73 m(2), Group C- T2DM subjects with an eGFR>60 ml/min per 1.73 m(2), and Group D - T2DM subjects with an eGFR <60 ml/ mm per 1.73 m(2). In both the T2DM and control groups, RBP4 levels were higher in subjects with an eGFR < 60 ml/min per 1.73 m(2) than in subjects with an eGFR >60 ml/min per 1.73 m(2). However, the difference was only significant between the control groups (p <0.05). After adjusting for age, gender, BMI, eGFR and the presence of T2DM, eGFR, not T2DM, was associated with plasma RBP4 levels (p<0.05). These results suggest among Asians the eGFR, but not the presence of T2DM, is a major determinant of RBP4 serum levels. The eGFR should be taken into account when evaluating the role of RBP4 in the pathogenesis of insulin resistance and T2DM. KW - retinol-binding protein 4 KW - renal function KW - type 2 diabetes mellitus KW - Asian subjects Y1 - 2011 SN - 0125-1562 VL - 42 IS - 4 SP - 936 EP - 945 PB - SEAMEO CY - Bangkok ER - TY - THES A1 - Verch, Ronald T1 - Whole-body electrical muscle stimulation superimposed walking as training tool in the management of type 2 diabetes mellitus T1 - Elektrische Ganzkörpermuskelstimulation überlagertes Gehen als Trainingsinstrument bei der Behandlung von Diabetes mellitus Typ 2 N2 - Background: The worldwide prevalence of diabetes has been increasing in recent years, with a projected prevalence of 700 million patients by 2045, leading to economic burdens on societies. Type 2 diabetes mellitus (T2DM), representing more than 95% of all diabetes cases, is a multifactorial metabolic disorder characterized by insulin resistance leading to an imbalance between insulin requirements and supply. Overweight and obesity are the main risk factors for developing type 2 diabetes mellitus. The lifestyle modification of following a healthy diet and physical activity are the primary successful treatment and prevention methods for type 2 diabetes mellitus. Problems may exist with patients not achieving recommended levels of physical activity. Electrical muscle stimulation (EMS) is an increasingly popular training method and has become in the focus of research in recent years. It involves the external application of an electric field to muscles, which can lead to muscle contraction. Positive effects of EMS training have been found in healthy individuals as well as in various patient groups. New EMS devices offer a wide range of mobile applications for whole-body electrical muscle stimulation (WB-EMS) training, e.g., the intensification of dynamic low-intensity endurance exercises through WB-EMS. This dissertation project aims to investigate whether WB-EMS is suitable for intensifying low-intensive dynamic exercises such as walking and Nordic walking. Methods: Two independent studies were conducted. The first study aimed to investigate the reliability of exercise parameters during the 10-meter Incremental Shuttle Walk Test (10MISWT) using superimposed WB-EMS (research question 1, sub-question a) and the difference in exercise intensity compared to conventional walking (CON-W, research question 1, sub-question b). The second study aimed to compare differences in exercise parameters between superimposed WB-EMS (WB-EMS-W) and conventional walking (CON-W), as well as between superimposed WB-EMS (WB-EMS-NW) and conventional Nordic walking (CON-NW) on a treadmill (research question 2). Both studies took place in participant groups of healthy, moderately active men aged 35-70 years. During all measurements, the Easy Motion Skin® WB-EMS low frequency stimulation device with adjustable intensities for eight muscle groups was used. The current intensity was individually adjusted for each participant at each trial to ensure safety, avoiding pain and muscle cramps. In study 1, thirteen individuals were included for each sub question. A randomized cross-over design with three measurement appointments used was to avoid confounding factors such as delayed onset muscle soreness. The 10MISWT was performed until the participants no longer met the criteria of the test and recording five outcome measures: peak oxygen uptake (VO2peak), relative VO2peak (rel.VO2peak), maximum walk distance (MWD), blood lactate concentration, and the rate of perceived exertion (RPE). Eleven participants were included in study 2. A randomized cross-over design in a study with four measurement appointments was used to avoid confounding factors. A treadmill test protocol at constant velocity (6.5 m/s) was developed to compare exercise intensities. Oxygen uptake (VO2), relative VO2 (rel.VO2) blood lactate, and the RPE were used as outcome variables. Test-retest reliability between measurements was determined using a compilation of absolute and relative measures of reliability. Outcome measures in study 2 were studied using multifactorial analyses of variances. Results: Reliability analysis showed good reliability for VO2peak, rel.VO2peak, MWD and RPE with no statistically significant difference for WB-EMS-W during 10WISWT. However, differences compared to conventional walking in outcome variables were not found. The analysis of the treadmill tests showed significant effects for the factors CON/WB-EMS and W/NW for the outcome variables VO2, rel.VO2 and lactate, with both factors leading to higher results. However, the difference in VO2 and relative VO2 is within the range of biological variability of ± 12%. The factor combination EMS∗W/NW is statistically non-significant for all three variables. WB-EMS resulted in the higher RPE values, RPE differences for W/NW and EMS∗W/NW were not significant. Discussion: The present project found good reliability for measuring VO2peak, rel. VO2peak, MWD and RPE during 10MISWT during WB-EMS-W, confirming prior research of the test. The test appears technically limited rather than physiologically in healthy, moderately active men. However, it is unsuitable for investigating differences in exercise intensities using WB-EMS-W compared to CON-W due to different perceptions of current intensity between exercise and rest. A treadmill test with constant walking speed was conducted to adjust individual maximum tolerable current intensity for the second part of the project. The treadmill test showed a significant increase in metabolic demands during WB-EMS-W and WB-EMS-NW by an increased VO2 and blood lactate concentration. However, the clinical relevance of these findings remains debatable. The study also found that WB-EMS superimposed exercises are perceived as more strenuous than conventional exercise. While in parts comparable studies lead to higher results for VO2, our results are in line with those of other studies using the same frequency. Due to the minor clinical relevance the use of WB-EMS as exercise intensification tool during walking and Nordic walking is limited. High device cost should be considered. Habituation to WB-EMS could increase current intensity tolerance and VO2 and make it a meaningful method in the treatment of T2DM. Recent figures show that WB-EMS is used in obese people to achieve health and weight goals. The supposed benefit should be further investigated scientifically. N2 - Hintergrund: Die weltweite Prävalenz von Diabetes hat in den letzten Jahren zugenommen. Bis zum Jahr 2045 wird mit einer Prävalenz von 700 Millionen Patienten gerechnet, was zu einer wirtschaftlichen Belastung für die Gesellschaft führt. Diabetes mellitus Typ 2, der mehr als 95 % aller Diabetesfälle ausmacht, ist eine multifaktorielle Stoffwechselstörung, die durch Insulinresistenz gekennzeichnet ist und zu einem Ungleichgewicht zwischen Insulinbedarf und -angebot führt. Übergewicht und Adipositas sind die Hauptrisikofaktoren für die Entwicklung von Diabetes mellitus Typ 2. Die Änderung des Lebensstils durch eine gesunde Ernährung und körperliche Aktivität ist die wichtigste und erfolgreichste Behandlungs- und Präventionsmethode für Diabetes mellitus Typ 2. Probleme können bei den Patienten bestehen, den empfohlenen Umfang an körperlicher Aktivität zu erreichen. Die elektrische Muskelstimulation (EMS) ist eine zunehmend beliebte Trainingsmethode, die in den letzten Jahren in den Mittelpunkt der Forschung gerückt ist. Dabei wird von außen ein elektrisches Feld an die Muskeln angelegt, was zu einer Muskelkontraktion führen kann. Positive Effekte des EMS-Trainings wurden sowohl bei gesunden Personen als auch in verschiedenen Patientengruppen gefunden. Neue EMS-Geräte bieten eine breite Palette mobiler Anwendungen für das Ganzkörper-EMS-Training (WB-EMS), z.B. die Intensivierung von dynamischen Ausdauerübungen mit niedriger Intensität durch WB-EMS. In diesem Dissertationsprojekt soll untersucht werden, ob die WB-EMS zur Intensivierung von dynamischen Übungen mit geringer Intensität wie Walking und Nordic Walking geeignet ist. Methodik: Zwei unabhängige Studien wurden durchgeführt. In der ersten Studie wurden die Zuverlässigkeit von Belastungsparametern während des 10-Meter-Inkremental-Penlde-Gehtests (10MISWT) unter Verwendung von überlagertem WB-EMS (Forschungsfrage 1, Unterfrage a) und der Unterschied in der Belastungsintensität zum konventionellen Gehen (Forschungsfrage 1, Unterfrage b) untersucht. Die zweite Studie beschäftigte sich mit Unterschieden in Belastungsparametern zwischen überlagertem WB-EMS (WB-EMS-W) und konventionellem Gehen (CON-W) sowie zwischen überlagertem WB-EMS (WB-EMS-NW) und konventionellem Nordic Walking (CON-NW) auf einem Laufband zu vergleichen (Forschungsfrage 2). Beide Studien wurden an Teilnehmergruppen von gesunden, mäßig aktiven Männern im Alter von 35-70 Jahren durchgeführt. Bei allen Messungen wurde das Niederfrequenz-Stimulationsgerät Easy Motion Skin® für WB-EMS mit einstellbaren Intensitäten für acht Muskelgruppen verwendet. Um die Sicherheit zu gewährleisten und Schmerzen und Muskelkrämpfe zu vermeiden, wurde die Stromintensität für jeden Teilnehmer bei jedem Versuch individuell angepasst. In Studie 1 wurden dreizehn Personen für jede Unterfrage einbezogen. Es wurde ein randomisiertes Cross-over-Design mit drei Messterminen verwendet, um Störfaktoren wie z. B. einen verzögert einsetzenden Muskelkater zu vermeiden. Der 10MISWT wurde so lange durchgeführt, bis die Teilnehmer die Kriterien des Tests, das Erreichen des Kegels bis zum nächsten akustischen Signal, nicht mehr erfüllten. Fünf Ergebnisgrößen erfasst wurden: Spitzenwertmessung der Sauerstoffaufnahme (VO2peak), relative VO2peak (rel.VO2peak), maximale Gehstrecke (MWD), Blutlaktatkonzentration und der Grad der wahrgenommenen Anstrengung (RPE). Elf Teilnehmer wurden in Studie 2 eingeschlossen. Um Störfaktoren zu vermeiden, wurde ein randomisiertes Cross-over-Design in einer Studie mit vier Messterminen verwendet. Es wurde ein Laufbandtestprotokoll mit konstanter Geschwindigkeit (6,5 m/s) entwickelt, um die Belastungsintensitäten zu vergleichen. Sauerstoffaufnahme (VO2), relative VO2 (rel. VO2), Blutlaktat und der RPE wurden als Ergebnisvariablen verwendet. Die Test-Retest-Reproduzierbarkeit zwischen den Messungen wurde anhand einer Zusammenstellung absoluter und relativer Zuverlässigkeitsmaße ermittelt. Die Ergebnisgrößen in Studie 2 wurden mit Hilfe multifaktorieller Varianzanalysen untersucht. Ergebnisse: Die Reliabilitätsanalyse zeigte eine gute Zuverlässigkeit für VO2peak, rel.VO2peak, MWD und RPE ohne statistisch signifikanten Unterschied für das WB-EMS überlagerte Gehen zwischen den beiden Messungen während des 10WISWT. Es wurden jedoch keine Unterschiede bei den Ergebnisvariablen im Vergleich zum konventionellen Gehen festgestellt. Die Analyse der Laufbandtests zeigte signifikante Effekte für die Faktoren CON/WB-EMS und W/NW für die Ergebnisvariablen VO2, rel.VO2 und Laktat, wobei beide Faktoren zu höheren Ergebnissen führten. Der Unterschied bei VO2 und rel.VO2 liegt jedoch im Bereich der biologischen Variabilität von ± 12 %. Die Faktorenkombination EMS∗W/NW ist für alle drei Variablen statistisch nicht signifikant. WB-EMS führte zu den höheren RPE-Werten, die RPE-Unterschiede für W/NW und EMS∗W/NW waren nicht signifikant. Diskussion: Das vorliegende Projekt ergab eine gute Zuverlässigkeit bei der Messung von VO2peak, rel.VO2peak, MWD und RPE während des 10MISWT mit WB-EMS-Überlagerung beim Gehen, was frühere Untersuchungen zu diesem Test bestätigen. Der Test scheint bei gesunden, mäßig aktiven Männern eher technisch als physiologisch begrenzt zu sein. Er ist jedoch ungeeignet für die Untersuchung von Unterschieden in der Belastungsintensität bei überlagertem WB-EMS im Vergleich zum herkömmlichen Gehen, da die Stromstärkenintensität des WB-EMS zwischen Belastung und Ruhe unterschiedlich wahrgenommen wird. Für den zweiten Teil des Projekts wurde ein Laufbandtest mit konstanter Gehgeschwindigkeit durchgeführt, um die individuell maximal tolerierbare Stromintensität während der Belastung einzustellen. Der Laufbandtest zeigte eine signifikante Erhöhung der metabolischen Anforderungen während des WB-EMS überlagerten Gehens und des Nordic Walking durch eine erhöhte VO2 und Blutlaktatkonzentration. Die klinische Relevanz dieser Ergebnisse bleibt jedoch umstritten. Die Studie ergab auch, dass WB-EMS-überlagerte Übungen als anstrengender empfunden werden als konventionelle Übungen. Während vergleichbare Studien zum Teil zu höheren VO2-Werten führen, stimmen unsere Ergebnisse mit denen anderer Studien überein, welche dieselbe Stromfrequenz verwenden. Aufgrund der bisher fehlenden klinischen Relevanz ist der Einsatz von WB-EMS zur Trainingsintensivierung beim Gehen und Nordic Walking begrenzt. Die hohen Gerätekosten sollten berücksichtigt werden. Die Gewöhnung an WB-EMS könnte die Toleranz gegenüber der aktuellen Intensität erhöhen, die VO2 weiter steigern und es zu einer sinnvollen Methode für die Behandlung von T2DM machen. Jüngste Zahlen zeigen, dass WB-EMS bei adipösen Menschen eingesetzt wird, um Gesundheits- und Gewichtsziele zu erreichen, der vermeintliche Nutzen sollte wissenschaftlich weiter untersucht werden. KW - whole-body electrical muscle stimulation KW - walking KW - type 2 diabetes mellitus KW - Diabetes mellitus Typ 2 KW - Gehen KW - elektrische Ganzkörpermuskelstimulation Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-634240 ER - TY - THES A1 - Wegewitz, Uta Elke T1 - Genetische und metabolische Regulation von Adiponectin : Resultate von in vitro und humanen in vivo Studien T1 - Genetic and metabolic regulation of adiponectin : results of in vitro and human in vivo studies N2 - Übergewicht, Diabetes oder Fettstoffwechselstörungen sind mit erniedrigten Adiponectinspiegeln assoziiert. Eine Modulation des Adiponectins kann durch genetische und metabolische Gegebenheiten erfolgen. Das Ziel dieser Arbeit war die Analyse von Faktoren, welche die Adiponectinspiegel beeinflussen können, sowie eine Charakterisierung der Oligomerverteilung unter verschiedenen metabolischen Bedingungen. In der MeSyBePo-Kohorte waren die zirkulierenden Adiponectinspiegel mit den Promotorpolymorphismen ADIPOQ -11377 C/G und ADIPOQ -11391 G/A im Adiponectingen assoziiert. Im Hinblick auf die metabolischen Faktoren korrelierte Adiponectin eng mit Parametern des Glukose- und Fettstoffwechsels sowie dem Übergewicht. Innerhalb von hyperinsulinämischen euglykämischen Clamps führte eine akute Hyperinsulinämie zu einer Abnahme der Adiponectinspiegel. Adiponectin zirkuliert im Serum als hochmolekulare (HMW), mittelmolekulare (MMW) und niedrigmolekulare (LMW) Spezies. Mit zunehmendem Körpergewicht konnte eine Verlagerung von HMW-Spezies hin zu den LMW-Spezies beobachtet werden. Durch eine moderate Gewichtsabnahme erhöhten sich die Anteile an HMW- und MMW-Adiponectin wieder. Während sich in Abhängigkeit vom Glukosemetabolismus keine Unterschiede in den Gesamtspiegeln ergaben, wurden bei Personen mit normaler Glukosetoleranz signifikant höhere Anteile an MMW-Adiponectin detektiert als bei Personen mit einem gestörten Glukosestoffwechsel. Insgesamt scheinen die HMW- und MMW-Spezies gegensätzlich zur LMW-Spezies reguliert zu werden. Die Arbeit unterstreicht die wichtige Rolle des Adiponectins im Glukose- und Fettstoffwechsel sowie bei einer Adipositas in vivo. Dabei waren Änderungen der Adiponectinspiegel bei Vorliegen von Insulinresistenz und Adipositas stets mit einer Umverteilung der Oligomerfraktionen verbunden. Vor allem die HMW- und MMW-Spezies des Adiponectins scheinen von entscheidender Bedeutung zu sein. N2 - Experimental data suggest that a dysregulation of adiponectin might be involved in the development of the metabolic syndrome. Adiponectin circulates as a variety of multimeric forms and its concentration was found to be decreased in obesity, type 2 diabetes mellitus, and dyslipidemia. Polymorphisms within the adiponectin gene, as well as the metabolic status, may modulate the adiponectin level. The aim of this work was to evaluate factors that may modulate total adiponectin levels as well as the distribution of its multimeric complexes under specific metabolic conditions. In the caucasian MeSyBePo population, serum adiponectin concentrations were associated with two promoter polymorphisms, ADIPOQ -11377 C/G and ADIPOQ -11391 G/A, respectively. Mean serum adiponectin levels were related to obesity, glucose metabolism, and lipid metabolism. Additionally, hyperinsulinemic euglycemic clamps acutely lowered serum adiponectin concentration. Adiponectin circulates in serum as low-, medium-, and high-molecular-weight complexes (LMW, MMW, and HMW, respectively). Adiponectin oligomer composition was related to BMI, with decreased HMW and MMW fractions in case of high BMI levels. According to this, HMW and MMW adiponectin increased after moderate weight reduction. While total adiponectin levels were comparable between patients with type 2 diabetes and control subjects, a reduction of MMW oligomers was observed in patients with impaired glucose metabolism. Finally, these studies all suggested a differential regulation of HMW and MMW species compared to the LMW fraction. The data presented underline the important role of adiponectin within the glucose- and lipid metabolism as well as in obesity. We showed that modulation of total adiponectin levels in case of insulin resistance or obesity are always accompanied with changes of adiponectin oligomer composition. Thereby the HMW and MMW species seem to play a crucial role in affecting metabolic changes. KW - Adioponectin KW - Adipositas KW - Typ-2-Diabetes mellitus KW - Metabolisches Syndrom KW - Oligomere KW - adiponectin KW - obesity KW - type 2 diabetes mellitus KW - metabolic syndrome KW - oligomers Y1 - 2007 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus-16062 ER -