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To evaluate the relationship between serum adiponectin level, dietary intake, and metabolic syndrome (MetS) in type 2 diabetes mellitus (DM) patients, and to identify factors associated with serum adiponectin level.A cross-sectional study was performed using 789 type 2 DM patients (406 men and 383 women) 40-80 years old. Subjects were classified into 3 groups on the basis of serum adiponectin level. General characteristics and anthropometric, hematologic, and dietary data were obtained for each subject.The prevalence of hypoadiponectinemia (4.0 µg/mL) was 57.4% in men and 32.4% in women. Serum adiponectin level was negatively correlated with body mass index (BMI), waist circumference, body fat percentage, and serum concentrations of insulin and triglyceride, and was positively correlated with high-density lipoprotein (HDL)-cholesterol level. Even though the direct association of nutrient intake with serum adiponectin concentration was not strong, various contributing factors for hypoadiponectinemia were strongly correlated with micronutrient intake, such as calcium, iron, and niacin. Both sexes in the group with the lowest adiponectin concentration had a higher prevalence of MetS and MetS components than corresponding sexes in the group with the highest adiponectin concentration.Our findings show that hypoadiponectinemia is strongly associated with MetS in type 2 DM patients. Dietary intake may be indirectly associated with adiponectin levels through factors such as BMI, waist circumference, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride, HDL-cholesterol, and blood pressure. Therefore, our results suggest that manipulation of the level of adiponectin may prevent MetS and reduce the risk of cardiovascular disease in type 2 DM patients.

The SNP276GT polymorphism in the adiponectin gene has been reported to be associated with type 2 diabetes and impaired glucose tolerance. The objective of this study was to examine whether SNP276GT polymorphism influences the blood glucose levels in relation to dietary carbohydrate intake.In an ongoing, prospective study, 673 patients with type 2 diabetes (339 men and 334 women, aged 40-85 years) were recruited from one of two diabetes clinics in Seoul, Korea. The levels of carbohydrate intake were categorized as55%, 55%-65%, and65% of total energy intake.Significant gene-nutrient interactions between SNP276GT polymorphism and the level of carbohydrate intake were found, which modulated plasma fasting blood glucose (p=0.0277), HbA1C (p=0.0407), and high-density lipoprotein (HDL) cholesterol (p=0.0134) concentrations. The G allele was associated with higher fasting blood glucose only in subjects consuming a low-carbohydrate diet (55% of energy). However, when carbohydrate intake was intermediate (55%-65%), carriers of the T allele had greater fasting blood glucose and HbA1C concentrations. When carbohydrate intake was high (65%), carriers of the T allele had greater HDL cholesterol concentrations. This interaction was significant even when carbohydrate intake was considered a continuous variable (p=0.0200 for fasting blood glucose, p=0.0408 for HbA1C, and p=0.0254 for HDL cholesterol), suggesting a strong dose-response relation.Our data show that the effect of the SNP276GT polymorphism on plasma fasting blood glucose, HbA1C, and HDL cholesterol concentrations depends on dietary carbohydrate intake.