Emerging evidence suggests that adiponectin secreted from adipocytes may have a preventive effect on the development of type 2 diabetes, attributable to an increase in insulin sensitivity and suppression of inflammation. However, when the East Asian population is considered, dysfunction of insulin secretion, besides insulin resistance and inflammation, has been assumed to play a significant role in the development of diabetes. Thus, the aim of the present study was to examine whether there is an association between a decrease in serum total adiponectin level and the incidence of diabetes in male Japanese, with consideration of insulin secretory function. We here report a prospective occupational-based cohort study, which was conducted during 2010-2019 in Japan. Briefly, 851 male workers without diabetes aged over 20 years were followed up prospectively. Diabetes was defined as either: 1) fasting plasma glucose ≥ 126 mg/dl, 2) HbA1c ≥ 6.5%, 3) medication for hyperglycemia or 4) postprandial plasma glucose ≥ 200 mg/dl during the follow-up period. Hazard ratios (HRs) with 95% confidence intervals (CIs) of serum total adiponectin level for the incidence of diabetes were estimated using a Cox proportional hazards model. In multivariate analysis after adjusting for age, BMI, smoking habit, alcohol intake, regular exercise, family history of diabetes, HDL-C, triglyceride, hypertension and HOMA-β, HR of developing diabetes was 8.61 [95%CI: 1.87 to 39.77, P=0.01] in the lowest quartile of serum total adiponectin, compared with the highest quartile. Furthermore, the risk of diabetes was 36% higher (P<0.01) per 1 µg/ml decrement of serum total adiponectin level in the multivariate-adjusted model. These results suggest that serum total adiponectin level could be a biomarker for the onset of diabetes in male Japanese, even with consideration of the ability of fasting insulin secretion and adjustment of its impact.


A. Hata: None. M. Miyoshi: None. T. Nakao: None. T. Ichihara: None. A. Tamura: None. T. Minagawa: None. Y. Kuwamura: None. M. Funaki: Board Member; Self; Mechanogenic, Inc., Consultant; Self; Happy, Inc., Research Support; Self; Japan Tobacco Inc.

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