Original Articles
7 October 2025
Early Access
The role of adiponectin in diabetic retinopathy and insulin resistance
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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Diabetic retinopathy (DR) is a common microvascular complication of type 2 diabetes mellitus (T2DM). The pathogenesis of DR is multifactorial, involving chronic hyperglycemia, oxidative stress, inflammation, and insulin resistance (IR), all of which contribute to microvascular damage in the retina. This study aimed to evaluate the role of adiponectin (APN) in DR and its correlation with IR, inflammatory and glycemic control. A total of 100 T2DM patients were enrolled and equally divided into two groups based on the presence or absence of DR. Demographic characteristics, glycemic indices, IR, inflammatory markers, and serum APN levels were analyzed. The diagnostic performance of APN was assessed using receiver operating characteristic (ROC) curve analysis. Patients with DR had a significantly longer duration of diabetes compared to those without DR (p<0.001). Biochemically, the DR group showed significantly higher levels of fasting blood sugar (p=0.025), hemoglobin A1C (p=0.003), fasting insulin (p=0.005), homeostatic model assessment for IR (p=0.001), and C-reactive protein (p<0.001). Conversely, the median serum APN levels were significantly lower in DR patients (median: 2.65 ng/mL) than in those without DR (median: 5.36 ng/mL; p<0.001). ROC analysis revealed that APN had a fair diagnostic performance for detecting DR (area under the curve: 0.773, 95% confidence interval: 0.679-0.867, p<0.001). DR is associated with poor glycemic control, increased IR, elevated inflammatory markers, and reduced serum APN levels. APN may serve as a potential biomarker for the detection and risk stratification of DR in T2DM patients.
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The role of adiponectin in diabetic retinopathy and insulin resistance. (2025). Italian Journal of Medicine. https://doi.org/10.4081/itjm.2025.2049
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