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      Circulating Levels of Resistin and Risk of Type 2 Diabetes in Men and Women: Results From Two Prospective Cohorts

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          Abstract

          OBJECTIVE—The purpose of this study was to investigate the role of circulating resistin levels in the development of type 2 diabetes using two prospective cohorts of well-characterized men and women.

          RESEARCH DESIGN AND METHODS—We conducted two prospective case-control studies nested in the Women's Health Study (WHS) and Physicians’ Health Study II (PHS II). In the WHS, during a median of 10-years of follow-up, 359 postmenopausal women, who were apparently healthy at baseline and later developed type 2 diabetes, were prospectively matched with 359 healthy control subjects. In the PHS II, with 8 years of total follow-up, 170 men, who were apparently healthy at baseline and later developed type 2 diabetes, were matched with 170 healthy control subjects. Control subjects were matched by age, race, and time of blood draw.

          RESULTS—Resistin levels at baseline were significantly higher in women than in men ( P = 0.003) and in case patients than in control subjects for both women ( P < 0.001) and men ( P = 0.07). After adjustment for matching factors, physical activity, alcohol intake, smoking, and family history of diabetes, the relative risk of type 2 diabetes comparing the highest to the lowest quartile of resistin in women was 2.22 ([95% CI 1.32–3.73]; P trend = 0.002). This association was attenuated after further adjustment for BMI (1.51 [0.86–2.65]; P trend = 0.20) or C-reactive protein (1.18 [0.68–2.07]; P trend = 0.60). A similar but weaker pattern was observed in men.

          CONCLUSIONS—Elevated levels of circulating resistin were significantly related to increased risk of type 2 diabetes, which appears to be partially accounted for by adiposity and the inflammatory process.

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            Resistin, an adipokine with potent proinflammatory properties.

            The adipokine resistin is suggested to be an important link between obesity and insulin resistance. In the present study, we assessed the impact of resistin as inflammatogenic cytokine in the setting of arthritis. In vitro experiments on human PBMC were performed to assess cytokine response and transcription pathways of resistin-induced inflammation. Proinflammatory properties of resistin were evaluated in animal model by intra-articular injection of resistin followed by histological evaluation of the joint. Levels of resistin were assessed by ELISA in 74 paired blood and synovial fluid samples of patients with rheumatoid arthritis. Results were compared with the control group comprised blood samples from 34 healthy individuals and 21 synovial fluids from patients with noninflammatory joint diseases. We now show that resistin displays potent proinflammatory properties by 1) strongly up-regulating IL-6 and TNF-alpha, 2) responding to TNF-alpha challenge, 3) enhancing its own activity by a positive feedback, and finally 4) inducing arthritis when injected into healthy mouse joints. Proinflammatory properties of resistin were abrogated by NF-kappaB inhibitor indicating the importance of NF-kappaB signaling pathway for resistin-induced inflammation. Resistin is also shown to specifically accumulate in the inflamed joints of patients with rheumatoid arthritis and its levels correlate with other markers of inflammation. Our results indicate that resistin is a new and important member of the cytokine family with potent regulatory functions. Importantly, the identified properties of resistin make it a novel and interesting therapeutic target in chronic inflammatory diseases such as rheumatoid arthritis.
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              A prospective study of red meat consumption and type 2 diabetes in middle-aged and elderly women: the women's health study.

              The aim of this study was to prospectively assess the relation between red meat intake and incidence of type 2 diabetes. Over an average of 8.8 years, we evaluated 37,309 participants in the Women's Health Study aged >/=45 years who were free of cardiovascular disease, cancer, and type 2 diabetes and completed validated semiquantitative food frequency questionnaires in 1993. During 326,876 person-years of follow-up, we documented 1,558 incident cases of type 2 diabetes. After adjusting for age, BMI, total energy intake, exercise, alcohol intake, cigarette smoking, and family history of diabetes, we found positive associations between intakes of red meat and processed meat and risk of type 2 diabetes. Comparing women in the highest quintile with those in the lowest quintile, the multivariate-adjusted relative risks (RRs) of type 2 diabetes were 1.28 for red meat (95% CI 1.07-1.53, P /=5/week vs. /=2/week vs. /=2/week vs. <1/week, P = 0.003 for trend). These results remained significant after further adjustment for intakes of dietary fiber, magnesium, glycemic load, and total fat. Intakes of total cholesterol, animal protein, and heme iron were also significantly associated with a higher risk of type 2 diabetes. Our data indicate that higher consumption of total red meat, especially various processed meats, may increase risk of developing type 2 diabetes in women.
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                Author and article information

                Journal
                Diabetes Care
                diacare
                Diabetes Care
                American Diabetes Association
                0149-5992
                1935-5548
                February 2009
                : 32
                : 2
                : 329-334
                Affiliations
                [1 ]Program on Genomics and Nutrition, Department of Epidemiology, UCLA School of Public Health, Los Angeles, California
                [2 ]Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
                [3 ]Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
                [4 ]Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
                [5 ]Department of Physiological Science, University of California, Los Angeles, California
                [6 ]Department of Laboratory Medicine, Children's Hospital and Harvard Medical School, Boston, Massachusetts
                [7 ]Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, Massachusetts
                [8 ]Division of Aging, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
                [9 ]Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
                Author notes

                Corresponding author: Yiqing Song, ysong3@ 123456rics.bwh.harvard.edu

                Article
                322329
                10.2337/dc08-1625
                2628703
                18957529
                5db0caeb-72fd-4d4e-bdfb-6dd3a58175d4
                Copyright © 2009, American Diabetes Association

                Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

                History
                : 3 September 2008
                : 21 October 2008
                Categories
                Cardiovascular and Metabolic Risk

                Endocrinology & Diabetes
                Endocrinology & Diabetes

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