Thesis supervisor:
Margus Lember, University of Tartu
Tarvo Rajasalu (1969-2012)
Opponent:
Sirkka Keinänen-Kiukaanniemi, University of Oulu, Finland
Summary:
The prevalence of obesity, metabolic syndrome and type 2 diabetes has increased considerably in recent decades throughout the world, having a serious impact on health through complications. Adipose tissue is an important endocrine organ, which produces several factors, called adipocytokines, influencing the whole-body metabolism. One of the most attention received adipocytokines is adiponectin due to its protective effects on various tissues and organs.
The aims of the current study were to estimate the prevalence of obesity, impaired glucose regulation and metabolic syndrome in Estonian adult population and to analyse the gender-specific associations between high-molecular-weight (HMW) adiponectin levels and metabolic risk factors.
A population-based cross-sectional study was conducted in three different counties of Estonia. The study population (495 subjects) consisted of randomly selected adults, aged 20-74 years and was representative of the general Estonian population in terms of age and gender.
We found that the prevalence of obesity among the Estonian adult population (32%) was significantly higher than previously estimated. Of the Estonian adult population 20% had impaired glucose regulation: the prevalence of impaired fasting glucose, impaired glucose tolerance and diabetes was 5, 8 and 7%, respectively. The prevalence of metabolic syndrome was 26%. Younger man had significantly higher prevalence of metabolic syndrome compared with younger women, whereas there were no gender-specific differences in the older age-groups. The prevalence of obesity, diabetes and metabolic syndrome is comparable with recently reported data from other European countries. Hypoadiponectinemia was inversely associated with metabolic syndrome more strongly in women than in men. In metabolically healthy women, HMW adiponectin levels were associated with various metabolic risk factors, as HDL cholesterol, triglycerides and fasting insulin level, but this association was not found in metabolically healthy men. Of obese subjects 12% were metabolically healthy and had HMW adiponectin levels similar to those observed in normal weight subjects of both genders.