To Assess the Influence of Adiponectin Levels on Type 2 Diabetes Mellitus Among Myocardial Infarction Patients

Abstract

Introduction: Adiponectin, an adipokine with insulin-sensitizing properties, may play a key role in the metabolic trajectory following myocardial infarction. This longitudinal study investigated whether low baseline adiponectin levels predict new-onset Type 2 Diabetes Mellitus (T2DM) in STEMI survivors without prior diabetes. Objective: This longitudinal study aimed to evaluate the influence of baseline plasma adiponectin levels on the risk of developing new-onset Type 2 Diabetes Mellitus (T2DM) in ST-segment elevation myocardial infarction (STEMI) survivors without prior diabetes. Methods: We enrolled 540 non-diabetic patients treated with primary percutaneous coronary intervention (pPCI) at a tertiary care centre in Chennai. Baseline plasma adiponectin was measured using a validated assay. Participants were followed for two years via quarterly telephone interviews, with T2DM diagnosis confirmed via medical records. Cox proportional hazards regression, adjusted for confounders including HbA1c and waist circumference, was used to assess risk. Results: During follow-up, 24 participants developed T2DM. A strong inverse dose-response relationship was observed between adiponectin levels and T2DM risk. Compared to the highest adiponectin quartile (Q4), patients in the lowest quartile (Q1) had a more than four-fold higher unadjusted hazard ratio (HR 4.12, 95% CI 3.10–5.48), which remained significant after multivariable adjustment (adjusted HR 3.56, 95% CI 2.62–4.84, p<0.001). Higher baseline HbA1c was also an independent predictor (aHR 1.32 per %, 95% CI 1.15–1.51, p<0.001). Conclusion: Low circulating adiponectin is a powerful, independent predictor of new-onset T2DM in non-diabetic STEMI patients post-pPCI.