Effect of lifestyle modification on serum chemerin concentration and its association with insulin sensitivity in overweight and obese adults with type 2 diabetes

초록

Chemerin is a recently identified adipokine which has been reported to be associated with adiposity, insulin resistance, risk factors of metabolic syndrome and inflammation. In this study, we evaluated whether there are significant changes in HbA1c and serum chemerin levels after a 12 week lifestyle intervention in overweight and obese adults with type 2 diabetes. A total of 35 overweight or obese subjects with type 2 diabetes were randomized to receive intensive lifestyle modification including supervised exercise sessions or usual care for 12 weeks. Anthropometric and clinical data were collected before the intervention and after 12 weeks. There was a significant decrease in HbA1c (-1.0±0.5 vs 0.1±0.6 %, p<0.001), BMI (-1.3 ± 0.9 vs -0.1 ± 0.7 kg/m2, p<0.001) and total body fat content (fat percent change -3.7 ± 2.7 vs -0.4 ± 1.8 %, p<0.001) and a significant increase in VO2max (+3.7 ± 3.9 vs. -1.0 ± 2.7 ml/min/kg, p<0.001) in the intervention group compared to the usual care group after 12 weeks. Serum chemerin level was significantly decreased in the intervention group compared to the usual care group (-8.1±21.6 vs. +8.2±15.9 ng/ml, p=0.021). Baseline chemerin levels were positively correlated with HOMA-IR (r=0.36, p=0.04) and hsCRP (r=0.37, p=0.049) after adjustment for age and gender. Change in chemerin concentration during 12weeks was independently negatively correlated with change in insulin sensitivity index (β= -0.39, p=0.01) and positively correlated with change in fasting plasma glucose (β=0.32, p=0.029), total cholesterol (β=0.26, p=0.038), and lipocalin-2 (β=0.33, p=0.008). In conclusion, an intensive lifestyle intervention including supervised exercise was able to decrease serum chemerin level significantly. Decrease in serum chemerin level was associated with improved insulin sensitivity and this may be involved in the beneficial effects of lifestyle intervention in overweight and obese type 2 diabetic patients.