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 Table of Contents  
Year : 2022  |  Volume : 13  |  Issue : 4  |  Page : 331-339

Association of circulatory adiponectin with the parameters of Madras Diabetes Research Foundation-Indian Diabetes Risk Score

1 Department of Biochemistry, Integral Institute of Medical Sciences and Research (IIMS&R), Integral University, Lucknow, India; Department of Biochemistry, United Institute of Medical Sciences, Rawatpur, Prayagraj, India
2 Department of Biochemistry, King George’s Medical University (KGMU), Lucknow, India
3 Department of Biochemistry, Integral Institute of Medical Sciences and Research (IIMS&R), Integral University, Lucknow, India
4 Department of Biochemistry, United Institute of Medical Sciences, Rawatpur, Prayagraj, India
5 Department of Biochemistry, Integral Institute of Medical Sciences and Research (IIMS&R), Integral University, Lucknow, India; Department of Basic Medical Sciences, Integral Institute of Allied Health Sciences and Research (IIAHSR), Integral University, Lucknow, Uttar Pradesh, India

Date of Submission09-Aug-2022
Date of Decision07-Sep-2022
Date of Acceptance12-Sep-2022
Date of Web Publication21-Dec-2022

Correspondence Address:
Dr. Mohammad M Khan
Department of Basic Medical Sciences, Integral Institute of Allied Health Sciences and Research (IIAHSR), Integral University, Lucknow, Uttar Pradesh 226026
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jod.jod_86_22

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Introduction: Adiponectin (APN) is an adipose-derived protein. It has shown a variety of functions such as anti-inflammatory, anti-atherogenic, antidiabetic, and insulin-sensitizing and lipid-oxidation-enhancing activities. The APN levels have shown a significant relationship with the risk factors for type 2 diabetes mellitus (T2DM). As per the Madras Diabetes Research Foundation-Indian Diabetes Risk Score (MDRF-IDRS), Asian Indians have high risk factors for T2DM and its complications. APN levels influence the risk factors for T2DM and its complications. Its circulatory level also varied with the age, family history of T2DM, waist circumference, and level of physical activity. Aim: The purpose of this narrative review is to find the association of circulatory APN with the parameters of MDRS-IDRS. Materials and Methods: Articles were searched by various databases such as PubMed, MEDLINE, Scopus, Web of Science, and Google Scholar. Abstract, free full-text, and full-text articles were searched from the year 2003 to 2022. For this review, observational study, original articles, narrative review, systematic review, and meta-analysis articles published in the English language were included. It is needed to establish the association between the APN levels and the parameters of MDRF-IDRS. The modifiable risk factors of MDRF-IDRS may play a significant role to regulate the level of APN. The non-modifiable risk factors of MDRF-IDRS may help in the better management of APN levels and reduce the prevalence of T2DM. It is needed to clear that the APN levels influence the disease severities or not. It is also needed to improve the physical activity to regulate the APN level and to reduce the systemic inflammation and insulin resistance in Asian Indian population. Conclusion: Improvement in modifiable risk factors of MDRF-IDRS and level of APN may play a significant role in the therapeutic approach to prevent and/or delay the development of T2DM and its complications.

Keywords: Adiponectin, Indian Diabetes Risk Score, MDRF-IDRS, modifiable risk factors, non-modifiable risk factors, type 2 diabetes mellitus

How to cite this article:
Khan MD, Ahmad MK, Alam R, Khan S, Jaiswal G, Khan MM. Association of circulatory adiponectin with the parameters of Madras Diabetes Research Foundation-Indian Diabetes Risk Score. J Diabetol 2022;13:331-9

How to cite this URL:
Khan MD, Ahmad MK, Alam R, Khan S, Jaiswal G, Khan MM. Association of circulatory adiponectin with the parameters of Madras Diabetes Research Foundation-Indian Diabetes Risk Score. J Diabetol [serial online] 2022 [cited 2023 Jan 28];13:331-9. Available from: https://www.journalofdiabetology.org/text.asp?2022/13/4/331/364638

  Introduction Top

South Asian Indians have shown the high incidence of type 2 diabetes mellitus (T2DM) and faster development of T2DM from pre-T2DM. Dysfunction of pancreatic beta-cells and insulin resistance (IR) play a significant role in the pathophysiology of T2DM in South Asians. The study further suggested that the epidemic of T2DM is also spreading to rural areas of South Asia.[1],[2] It was further suggested that the increasing burden of T2DM is due to the high prevalence of overweight/obesity in India.[3] The inter-ethnic disparities were reported in the progression and development of T2DM and its associated complications. It is further suggested that ethnicity-specific biomarkers are required to develop the screening and diagnosis strategies to reduce the prognosis of T2DM and its associated complications.[4]

Adiponectin (APN) is a 30 kDa protein (244 amino acids) that consists of a signal peptide, a collagen-like domain, and a globular domain from N-terminus to the C-terminus. APN circulates as three multiple isoforms from low to medium to high molecular weight (LMW to MMW to HMW, respectively). The HMW is the most insulin-sensitizing isoform and abundantly present in plasma.[5],[6]

The circulating APN level in plasma has shown a very high range (2–30 µg/mL).[7] The circulating APN accounts 0.01% of the plasma proteins in adult individuals. The circulating level of APN varies with ethnicity. It is reported that the level of circulatory APN is low in Asian Indian population.[8],[9] The level of circulatory APN varies with gender and ethnicity.[10],[11]

There is a need to find a simple and cost-effective tool and a potential prognostic biomarker for screening of T2DM and cardiovascular disease (CVD), because genetic predisposition, dietary habits, and sedentary lifestyles are exponentially increasing the risk factors for obesity, hypertension, dyslipidemia, T2DM, and CVD in the Asian Indian population.


The purpose of this narrative review is to find the association of circulatory APN with the parameters of MDRS-IDRS.

  Materials and Methods Top

Article extraction source

Articles were searched by various databases such as PubMed, MEDLINE, Scopus, Web of Science, and Google Scholar.

Eligibility criteria for including the articles

Abstract, free full-text, and full-text articles were searched from the year 2003 to 2022. For this review, observational study, original articles, narrative review, systematic review, and meta-analysis articles published in the English language were included. Articles were included based on the research questions.

Research question

Is there any association between circulatory APN and the parameters of MDRF-IDRS?

The following keywords were used to search the articles: “Circulatory adiponectin + Age,” “Circulatory adiponectin + Waist Circumference,” “Circulatory adiponectin + Family History of T2DM,” “Circulatory adiponectin + Physical Activity,” “Adiponectin + IDRS,” “Adiponectin + Asian Indian Population,” “Modifiable Risk factors for Diabetes,” and “Non-Modifiable Risk factors for Diabetes.”

  Structure and Mechanism of Adiponectin Top

APN interacts with two different transmembrane receptors: (1) APN receptor 1 (AdipoR1) is expressed all over and at a high level in skeletal muscle and (2) APN receptor 2 (AdipoR2) is expressed mainly in the liver.[12],[13] APN receptors are also expressed in pancreatic β-cells, and their expression is increased by exposure to free fatty acids. It is suggested that APN and its receptors are also contributing in the insulin secretion and function.[14],[15] The AdipoR1 activates 5′-adenosine monophosphate-activated protein kinase (AMPK) and glucose transporter-4 (GLUT4) to increase the uptake of glucose in muscle cells.[16] It also inhibits the phosphoenolpyruvate carboxylase (PEPC) hepatic enzyme and blocks gluconeogenesis, stimulates fatty acids oxidation, and further inhibits the fatty acids synthesis.[12],[17] Moreover, APN also increases burning of fatty acid and energy utilization via activation of AdipoR2 through peroxisome proliferator-activated receptor-α (PPAR-α) and PPAR-γ activation. AdipoR2 activation increases the uptake of glucose and decreases the triglyceride (TG) in the liver and skeletal muscle, and it further increases the insulin sensitivity in vivo.[15],[17]

APN activates downstream actions via the cell surface receptors. In skeletal muscle, LMW and HMW isoforms of APN up-regulate PPAR-α and activate AMPK through the AdipoR1. In the liver, only the HMW and full-length APN can act through the AdipoR2.[13],[18] It is illustrated in [Figure 1].
Figure 1: Diagrammatic illustration of the APN action through its receptors on insulin sensitivity and energy expenditure.[12],[13] AdipoR1 and AdipoR2 = adiponectin receptor 1 and 2, AMPK = 5′-adenosine monophosphate-activated protein kinase, FFA = free fatty acid, LMW = low-molecular weight, HMW = high-molecular weight, PPAR-α = peroxisome proliferator-activated receptor-α (created by Biorender.com)

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  Circulatory Adiponectin Influencing Factors Top

APN is an adipose-derived protein, with multivalent functions including anti-inflammatory, antidiabetic, anti-atherogenic, insulin-sensitizing, and lipid-oxidation-enhancing activities.[19],[20] Several studies suggested that the high circulating APN level reduces the risk for obesity, IR, T2DM and its complications such as atherosclerosis and CVD.[21],[22] Circulating APN level has shown a significant negative association with adiposity.[23] Zhang et al.[24] stated that low levels of APN were found in persistent obesity in children also. Circulating APN and weight regain have a significant inverse relationship in therapy dropout obese children.[25] It might be possible that visceral fat accumulation produces inhibiting factors for the synthesis or secretion of APN, such as tumor necrosis factor-α (TNF-α).[23] It has been predicted that between 30% and 70% variability in the circulating level of APN is determined by genetic factors.[26] Adiponectin gene (ADIPOQ) variants were significantly linked with hypoadiponectinemia, obesity, metabolic syndrome (MetS), and T2DM and its complications.[27],[28],[29],[30] Some rare mutations in the ADIPOQ gene are disturbing the multimerization process of proteins that consequently affect the biological activity of proteins. The mutations in the ADIPOQ gene disturbed the assembling of trimeric and HMW multimeric forms of proteins that lead the clinical symptoms of hypoadiponectinemia. Low levels of HMW multimeric forms of proteins are strongly associated with diabetes and obesity. The gene was investigated for different variants that predispose to insulin sensitivity, metabolic disease, obesity, and T2DM and its complications such as coronary artery disease.[31],[32],[33] APN receptor T-cadherin is also associated with risk factor for CVD including atherosclerosis.[34],[35]

  Prevalence of T2DM Top

In India, it was estimated that more than 77 million people had diabetes in 2019 and it is projected to be over 134 million diabetes burden in India by 2045.[3] According to the International Diabetes Federation (IDF), the prevalence of diabetes is more than 10.4% in India. In addition, more than 57.9% of the people still have undiagnosed diabetes.[36] The prevalence of diabetes was found to be higher in urban (14.2%) than in rural (8.3%) population. However, the prevalence of prediabetes was equally distributed in urban (14.5%) and rural (14.7%) population.[37]

  Madras Diabetes Research Foundation-Indian Diabetes Risk Score (MDRF-IDRS) Top

Mohan et al.[38] suggested that Asian Indians have a specific phenotype and uniqueness in physical, biochemical, and clinical characteristics. Indians have higher waist circumference (WC) with lower body mass index (BMI) leading to greater abdominal adiposity, increased IR, higher high-sensitive C-reactive protein (hs-CRP), and lower circulating APN levels. Gupta et al.[39] reported that MDRF-IDRS was found to be the most sensitive and useful tool for the screening of T2DM and hypertension in rural India.

Previous studies suggested that there are two major kinds of risk factors for T2DM: (1) non-modifiable risk factors: age and family history of T2DM and (2) modifiable risk factors: abdominal obesity and physical activity. The MDRF-IDRS studies revealed that the individuals having an MDRF-IDRS score (≥60) are at high risk for T2DM and its complications. The MDRF-IDRS score was calculated by using parameters (age, waist circumference, physical activity, and family history of T2DM).[40],[41],[42],[43]

  Non-modifiable Risk Factors for T2DM Top


A study suggested that neonates have “thin fat phenotype” that further persisted in childhood and might be responsible for the diabetogenic phenotype in adults.[44] A study reported a high prevalence of IR in post-pubertal children due to the presence of excess body fat accumulation and abdominal adiposity in the metropolitan city Delhi.[45] According to the MDRF-IDRS, it is reported that Asian Indians are at high risk for T2DM and its complications.[40],[41],[42],[43] Asian Indians appear to have a high prevalence of macrovascular complications such as CVD compilations, whereas the prevalence of microvascular complications such as retinopathy and nephropathy was lower than that in Europeans.[46],[47]

The levels of plasma APN have shown an inverse relationship with body weight, fasting insulin concentrations, and homeostatic model assessment-insulin resistance (HOMA-IR) index in boys (aged 15–18 years) and in girls (aged 11–14 years). It is observed that the level of circulating APN reduced during male puberty and correlated with an increase in the testosterone level in boys. Due to this, body fat decreases and the early puberty adiposity may be disappeared in late puberty in boys.[48] The HMW adiponectin levels were lower and hs-CRP levels were higher in boys than in girls in late puberty. Young boys have shown additional abdominal fat and proinflammatory profile of biomarkers than girls.[49]

The study suggested that the cut-off value of circulating APN (5.1 μg/mL) can play a significant role in differentiating between T1DM and T2DM among young Asian Indians.[50] This cut-off point may well differ in other ethnic groups because of differences in the fat mass distribution and body weight in Indians.

The Indian Council of Medical Research–India Diabetes Study (ICMR-INDIAB) reported that above 15.5% of old age population (>65 years) are diabetic in India.[37] The low level of APN is associated with adipose tissue dysfunction in old age adults.[51] The risk of developing heart failure is significantly greater in obese menopausal women when compared with low BMI and WC menopausal women (≥55 years).[52] Women and older patients should be given more attention regarding the achievement of normal metabolic, adipose tissue, and endothelial functions to prevent or delay the T2DM complications and CVD.

Family history of T2DM

The circulating APN level has shown a significant correlation with a family history of T2DM. The circulating APN levels have been found to be significantly low in healthy individuals with a family history of T2DM when compared with healthy individuals without a family history of T2DM.

The progression of MetS to T2DM strongly linked with increased vascular adipose tissue, increased ectopic fat accumulation, and decreased level of APN in obese Japanese children, who have a family history of T2DM.[53] Similarly, the circulating APN level has shown a significant negative correlation with HOMA-IR and a strong association in individuals with family history of T2DM.[54] Genetic predisposition and presence of ADIPOQ gene variants were significantly linked with hypoadiponectinemia, obesity, and T2DM and its complications.[27],[28],[29],[30] This indicates that carrier of ADIPOQ gene variants that lead to hypoadiponectinemia may increase the risk factors for T2DM and its complications in individuals.

  Modifiable Risk Factors for T2DM Top

Abdominal obesity

WC is considered for the measurement of abdominal obesity. Abdominal obesity is a direct risk factor for CVD, independent of BMI.[55]

A negative correlation found between BMI and circulating APN levels could be because obesity leads to adipose tissue dysfunction. Indians have a higher degree of adiposity and body fat percentage than their Caucasian counterparts. However, Indians have low BMI.[56] Asian Indians have above 2-folds high prevalence of low BMI in young-onset diabetes (YOD) when compared with white Europeans. Asian Indians with low BMI in YOD have shown low beta-cell function.[57]

When adipose tissue fat storage capacity exceeded, further any nutritional excess will result in metabolic disturbance such as inflammation and IR.[58]

The distribution of obesity profiles [BMI, WC, and waist-to-hip ratio (WHR)] was found to have significant differences between cases and controls. Central obesity and high BMI were observed to increase the risk of T2DM.[42],[59] In postmenopausal obese women, the BMI and WC independently associated with visceral adipose tissue (VAT), circulating APN mRNA, triglycerides, and high-density lipoprotein. This suggested that the circulating APN has a potential modulatory role in lipid metabolism.[21]

For Asian Indian adults, the normal cut-off values for BMI (23 kg/m2 for both sexes) and WHR (0.88 and 0.81, for men and women, respectively) were suggested.[8],[56] It was observed that the Aggarwals of Delhi have higher mean values for BMI and WHR than these cut-off values.[60] Despite common, culturally embedded risk-prone lifestyle practices for both cases and controls, WHR was still found to have a significant effect on T2DM.[8],[42],[59]

A study on survivors and non-survivors of diabetic patients reported that the mean BMI for all T2DM patients (survivors and non-survivors) was higher than that of long-term survivors.[61] The average T2DM patients were obese than the long-term survivors.[41] In addition, it was reported that the HMW APN concentrations found a negative correlation with BMI and HOMA-IR in the T2DM patients.[20],[62]

Physical activity

Physical exercise is linked with an increase in the plasma level of APN and a decrease in the level of leptin and interleukin-6 (IL-6) in obese children, reducing the systematic inflammation.[63] Plasma APN concentrations also demonstrated a significant inverse relationship with levels of physical activity.[64] The response exercise and level of APN are related with the amount of adipose tissue and type of exercise.[65] The aerobic exercise significantly increases the APN levels and reduces the leptin levels in pre-diabetic and diabetic adults.[66] It is further reported that the physical activity may change the level of different isoforms of APN, especially the HMW isoform. The ratio of APN multimer isoforms may be changed by physical activity, which further may increase the biologically active form of plasma APN.[67]

A meta-analysis study reported that the physical exercise increases the circulatory APN levels in childhood obese subjects.[62] Similarly, physical exercise, mainly, aerobic exercise, can also increase the APN levels in pre-diabetic and diabetic adults.[65] It was reported that replacing the sedentary time (60 min) with light-intensity physical activity (60 min) increases the HMW (13%) and total APN levels (9%) in men.[68]

Intake of refined grain and decreased physical activity are associated with increased risk factors of diabetes in Asian Indian ethnic groups.[40],[69] Recently, it has been reported that regular drinking of sugar-sweetened beverages (SSBs) significantly contributes to weight gain and increases high risk factors for abdominal obesity, T2DM, and CVD in high-to-low-income countries equally.[70]

Anjana et al.[71] reported that more than only around 10% of people of India are physically active. It was further reported that around 57% of people of India do not match the recommended level of physical activity regimen.[72] It is suggested that urgent action needs to be taken to encourage the physical activity and to reduce the intake of SSBs in general population to reduce the burden of abdominal obesity and T2DM and its complications such as CVD in India.

  Systemic Inflammation, Insulin Resistance (IR), APN, and the Parameters of MDRF-IDRS are Linked Together Top

Obese adipose tissue secretes inflammatory markers (IL-6, CRP, and TNF-α) that directly mediate systemic inflammation and contribute to IR, T2DM, and CVD.[58]

Systemic inflammation in adipose tissue is resulting in visceral adiposity. Several studies hypothesized that a strong correlation exists between inflammation in adipose tissue and IR. Adipocytes and macrophages of adipose tissue produce inflammatory markers that enhance excessive free fatty acid, increased resistin, decreased adiponectin, and accumulation of ceramide and ectopic fat in liver and skeletal muscle resulting in IR.[73] Macrophages of adipose tissue promote systemic inflammation that damages the β-cells of pancreas and enhances IR.[74]

IR plays a central role which is influenced by both modifiable and non-modifiable risk factors for T2DM [Figure 2]. Insulin sensitivity and IR are influenced by variable APN levels in different ethnicities. The study reported that the circulating APN level and adiposity have inverse association.[23]
Figure 2: Role of APN on modifiable risk factors for T2DM. CVD = cardiovascular disease, IL-6 = interleukin-6, MDRF-IDRS = Madras Diabetes Research Foundation-Indian Diabetes Risk Score, TNF-alpha = tumor necrosis factor-alpha, T2DM = type 2 diabetes mellitus (created by Biorender.com)

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South Asia has a high prevalence of T2DM and faster development from pre-diabetes to diabetes. Dysfunction of pancreatic beta-cell and IR play a significant role in the pathophysiology of T2DM in South Asians. The study further suggested that the epidemic of T2DM is also spreading to rural areas of South Asia.[1],[2] This may be due to the differences in overall abdominal fat and visceral fat deposition which may contribute to the high risk of abdominal obesity and T2DM in South Asians.[75] Most importantly, ethnicity variations were also reported between plasma HMW APN levels and HOMA-IR. South Asians have low plasma HMW APN levels, which cause a greater increase in HOMA-IR and increase the risk factor for T2DM.[4],[76],[77] Several studies have shown that South Asians (Asian-Indians) have higher levels of IR than Caucasians in the same level of BMI.[78]

It was reported that Asian Indian population has a high risk of T2DM microvascular complications such as retinopathy and chronic kidney disease due to the presence of insulin deficiency and IR in T2DM study groups.[79]

A follow-up of the original Chennai Urban Population Study cohort showed that the overall mortality rates are almost three times high in the diabetes group when compared with the non-diabetic group. The study showed significant high mortality due to CVD and renal disease in diabetic subjects than in non-diabetic subjects.[80]

In the Asian Indian population, Snehalatha et al.[8] found a low mean APN level in the diabetic group when compared with the non-diabetic group. In North Indian population, adjustment for age did not show any change in the mean APN levels but adjustment for sex did influence the mean values of APN levels.[81] It is further suggested that estrogen improves the regulation of APN in females and testosterone inhibits the production of APN in males.[82]

  Modifications in the Modifiable Risk Factors of MDRF-IDRS Regulate the Secretion and Function of APN Top

Modifiable risk factors of IDRS are abdominal obesity and physical activity. It was reported that the improvement in physical activity reduces the abdominal obesity by reducing the systemic inflammation.[83] Reduction in the systemic inflammation reduces the secretion of inflammatory markers such as TNF-α and hs-CRP.[84] Reduction in the inflammatory markers such as TNF-α and hs-CRP elevates the APN levels.[85] Elevated level of APN increases the insulin sensitivity and reduces IR.[86] Physical activity has shown a significant impact on abdominal obesity, systemic inflammation, and IR.[87]

WC and IR have shown a strong association.[88] In addition, a large sample size NHANES study reported that WC is a significant predictor of fasting glucose, HbA1c, and HOMA-IR when compared with BMI.[89] Long-term physical activity reduces the weight and WC and provides overall health benefits.[90] However, physical inactivity/sedentary lifestyle increases the risk factors of chronic diseases. However, physical activity reduces the risk of CVD by improving the muscle functions and regulating the metabolic activity and benefiting to overall health.[91] A systematic review and meta-analysis suggested that exercise intervention induces a significant physical function and alterations in biomarkers in old age hospitalized adults.[92]

Several studies reported that physical activity/exercise significantly improves the level of APN and reduces the risk of abdominal obesity, T2DM, cardiometabolic and endothelial dysfunctions, and immunological and chronic diseases.[51],[63]

An in-vitro study reported that APN significantly balances hyperglycemia at various molecular and cellular levels, thus reducing the pathophysiological impact and progression of diabetic retinopathy.[93] APN regulates various biological functions. More research is needed to develop the exercise therapy protocol to regulate the level and effect of APN to improve the overall metabolic health benefits.[63]

The inter-ethnic disparities were reported in the progression and development of T2DM and its associated complications. It is further suggested that ethnicity-specific biomarkers are required to develop the screening and diagnosis strategies to reduce the prognosis of T2DM and its associated complications.[4]

The ICMR-INDIAB study in India showed a positive response of ABC targets [good control of blood glucose (A), blood pressure (B), and low-density lipoprotein cholesterol (C)] in self-reported diabetes groups. The study further suggested that education and awareness of diabetes can be better ways to achieve ABC targets in Indian population.[94] In addition, the World Health Organization announced the formation of a Global Diabetes Compact to increase the awareness and achieve the ABC targets in individuals.[95]

It is reported that the newly diagnosed T2DM is at high risk of atherosclerotic CVD in India. The study further supported that an easy-to-use and cost-effective screening tool is required to screen the T2DM and its complications at a very early stage.[96] For this purpose, MDRF-IDRS and ethnic-specific biomarkers such as APN may play a significant role to reduce the incidence and progression of abdominal obesity and T2DM and its complications.

Strength and limitations

Mainly, Asian Indian population-based published articles were included for this current review. Systematic review and meta-analysis are required to establish the evidence-based association between circulatory APN levels and parameters of MDRF-IDRS.

  Conclusion Top

This review indicated that the circulatory APN level might play a key role in reducing the risk factors for T2DM and its complications in Asian Indians. This review emphasized that the APN level is significantly influenced by modifiable and non-modifiable risk factors of MDRF-IDRS. It is also needed to improve the physical activity to elevate the level of APN and to reduce the systemic inflammation and IR in Asian Indian population. Improvement in modifiable risk factors of MDRF-IDRS and level of APN may play a significant role in the therapeutic approach to prevent and/or delay the development of T2DM and its complications.


We are grateful to Dr. Gyanendra Kumar Sonkar, Professor, Department of Biochemistry, King George’s Medical University (KGMU), Lucknow, Uttar Pradesh, India. We also acknowledge Prof. (Dr.) Abha Chandra, Dean, Integral Institute of Medical Sciences and Research (IIMSR), Integral University, Lucknow, Uttar Pradesh, India for the invaluable help and suggestions to write this article without any hindrance.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Unnikrishnan R, Gupta PK, Mohan V Diabetes in South Asians: Phenotype, clinical presentation, and natural history. Curr Diab Rep 2018;18:30.  Back to cited text no. 1
Narayan KMV, Kanaya AM Why are South Asians prone to type 2 diabetes? A hypothesis based on underexplored pathways. Diabetologia 2020;63:1103-9.  Back to cited text no. 2
Pradeepa R, Mohan V Epidemiology of type 2 diabetes in India. Indian J Ophthalmol 2021;69:2932-8.  Back to cited text no. 3
Vasishta S, Ganesh K, Umakanth S, Joshi MB Ethnic disparities attributed to the manifestation in and response to type 2 diabetes: Insights from metabolomics. Metabolomics 2022;18:45.  Back to cited text no. 4
Lara-Castro C, Luo N, Wallace P, Klein RL, Garvey WT Adiponectin multimeric complexes and the metabolic syndrome trait cluster. Diabetes 2006;55:249-59.  Back to cited text no. 5
Hara K, Horikoshi M, Yamauchi T, Yago H, Miyazaki O, Ebinuma H, et al. Measurement of the high-molecular weight form of adiponectin in plasma is useful for the prediction of insulin resistance and metabolic syndrome. Diabetes Care 2006;29:1357-62.  Back to cited text no. 6
Rosman N, Froemming G, Effat O, Nawawi H, Singh H Effects of adiponectin on markers of endothelial activation and markers of inflammation in human coronary artery endothelial cells. J Fundam Appl Sci 2017;9:1102-15. doi:10.4314/jfas.v9i6s.81.  Back to cited text no. 7
Snehalatha C, Mukesh B, Simon M, Viswanathan V, Haffner SM, Ramachandran A Plasma adiponectin is an independent predictor of type 2 diabetes in Asian Indians. Diabetes Care 2003;26:3226-9.  Back to cited text no. 8
Diwan AG, Kuvalekar AA, Dharamsi S, Vora AM, Nikam VA, Ghadge AA Correlation of serum adiponectin and leptin levels in obesity and type 2 diabetes mellitus. Indian J Endocrinol Metab 2018;22:93-9.  Back to cited text no. 9
Jiang Y, Owei I, Wan J, Ebenibo S, Dagogo-Jack S Adiponectin levels predict prediabetes risk: The pathobiology of prediabetes in a Biracial Cohort (POP-ABC) study. BMJ Open Diabetes Res Care 2016;4:e000194.  Back to cited text no. 10
Goto A, Noda M, Goto M, Yasuda K, Mizoue T, Yamaji T, et al; JPHC Study Group. Plasma adiponectin levels, ADIPOQ variants, and incidence of type 2 diabetes: A nested case–control study. Diabetes Res Clin Pract 2017;127:254-64.  Back to cited text no. 11
Yamauchi T, Iwabu M, Okada-Iwabu M, Kadowaki T Adiponectin receptors: A review of their structure, function and how they work. Best Pract Res Clin Endocrinol Metab 2014;28:15-23.  Back to cited text no. 12
Khoramipour K, Chamari K, Hekmatikar AA, Ziyaiyan A, Taherkhani S, Elguindy NM, et al. Adiponectin: Structure, physiological functions, role in diseases, and effects of nutrition. Nutrients 2021;13:1180. doi:10.3390/nu13041180.  Back to cited text no. 13
Lim S, Quon MJ, Koh KK Modulation of adiponectin as a potential therapeutic strategy. Atherosclerosis 2014;233:721-8.  Back to cited text no. 14
Stern JH, Rutkowski JM, Scherer PE Adiponectin, leptin, and fatty acids in the maintenance of metabolic homeostasis through adipose tissue crosstalk. Cell Metab 2016;23:770-84.  Back to cited text no. 15
Fisman EZ, Tenenbaum A Adiponectin: A manifold therapeutic target for metabolic syndrome, diabetes, and coronary disease? Cardiovasc Diabetol 2014;13:103. doi:10.1186/1475-2840-13-103.  Back to cited text no. 16
Kadowaki T, Yamauchi T, Kubota N, Hara K, Ueki K, Tobe K Adiponectin and adiponectin receptors in insulin resistance, diabetes, and the metabolic syndrome. J Clin Invest 2006;116:1784-92.  Back to cited text no. 17
Kadowaki T, Yamauchi T Adiponectin and adiponectin receptors. Endocr Rev 2005;26:439-51.  Back to cited text no. 18
Achari AE, Jain SK Adiponectin, a therapeutic target for obesity, diabetes, and endothelial dysfunction. Int J Mol Sci 2017;18:1321. doi:10.3390/ijms18061321.  Back to cited text no. 19
Choi HM, Doss HM, Kim KS Multifaceted physiological roles of adiponectin in inflammation and diseases. Int J Mol Sci 2020;21:1219. doi:10.3390/ijms21041219.  Back to cited text no. 20
Yanai H, Yoshida H Beneficial effects of adiponectin on glucose and lipid metabolism and atherosclerotic progression: Mechanisms and perspectives. Int J Mol Sci 2019;20:1190. doi:10.3390/ijms20051190.  Back to cited text no. 21
Aljafary MA, Al-Suhaimi EA Adiponectin system (rescue hormone): The missing link between metabolic and cardiovascular diseases. Pharmaceutics 2022;14:1430. doi:10.3390/pharmaceutics14071430.  Back to cited text no. 22
Zaidi H, Aksnes T, Åkra S, Eggesbø HB, Byrkjeland R, Seljeflot I, et al. Abdominal adipose tissue associates with adiponectin and TNFα in middle-aged healthy men. Front Endocrinol 2022;13:874977.  Back to cited text no. 23
Zhang M, Cheng H, Zhao X, Hou D, Yan Y, Cianflone K, et al. Leptin and leptin-to-adiponectin ratio predict adiposity gain in nonobese children over a six-year period. Child Obes 2017;13:213-21.  Back to cited text no. 24
Vermeiren E, Van Eyck A, Van De Maele K, Ysebaert M, Makhout S, De Guchtenaere A, et al. The predictive value of adipokines and metabolic risk factors for dropouts and treatment outcomes in children with obesity treated in a pediatric rehabilitation center. Front Endocrinol (Lausanne) 2022;13:822962.  Back to cited text no. 25
Comuzzie AG, Funahashi T, Sonnenberg G, Martin LJ, Jacob HJ, Black AE, et al. The genetic basis of plasma variation in adiponectin, a global endophenotype for obesity and the metabolic syndrome. J Clin Endocrinol Metab 2001;86:4321-5.  Back to cited text no. 26
Vimaleswaran KS, Radha V, Ramya K, Babu HN, Savitha N, Roopa V, et al. A novel association of a polymorphism in the first intron of adiponectin gene with type 2 diabetes, obesity and hypoadiponectinemia in Asian Indians. Hum Genet 2008;123:599-605.  Back to cited text no. 27
Ramya K, Ayyappa KA, Ghosh S, Mohan V, Radha V Genetic association of ADIPOQ gene variants with type 2 diabetes, obesity and serum adiponectin levels in South Indian population. Gene 2013;532:253-62.  Back to cited text no. 28
Khan MM, Sonkar GK, Alam R, Singh S, MehrotraS, Sonkar SK Association of ADIPOQ gene variant rs266729 with circulatory adiponectin levels in patients with type 2 diabetes in North Indian population: A case–control study. Biomed Pharmacol J 2017;10:407-17.  Back to cited text no. 29
Khan MM, Alam R Association of +10211T/G (rs17846866) variant of adiponectin gene with type 2 diabetes mellitus. Biosci Biotechnol Res Asia 2019;16:569-76.  Back to cited text no. 30
Palit SP, Patel R, Jadeja SD, Rathwa N, Mahajan A, Ramachandran AV, et al. Publisher correction: A genetic analysis identifies a haplotype at adiponectin locus: Association with obesity and type 2 diabetes. Sci Rep 2020;10:7017.  Back to cited text no. 31
Zhu X, Hu J, Yang M, Guo H, Ji D, Li Y, et al. A genetic analysis identifies haplotype at adiponectin locus: Association with the metabolic health and obesity phenotypes. Gene 2021;784:145593.  Back to cited text no. 32
Simeone CA, Wilkerson JL, Poss AM, Banks JA, Varre JV, Guevara JL, et al. A dominant negative ADIPOQ mutation in a diabetic family with renal disease, hypoadiponectinemia, and hyperceramidemia. NPJ Genom Med 2022;7:43.  Back to cited text no. 33
Khan MD, Ahmad MK, Raj P, Khan MM Association of adiponectin and t-cadherin with cardiovascular disease—A review article. J Cardiovasc Dis Res 2021;12:1862-8.  Back to cited text no. 34
Khan MD, Ahmad MK, Alam R, Khan F, Khan MM Circulatory T-cadherin is a potential biomarker for atherosclerosis. Biomedicine 2022;42:417-21.  Back to cited text no. 35
IDF: International Diabetes Federation. IDF Diabetes Atlas. 10th ed. Brussels, Belgium: International Diabetes Federation; 2021. ISBN: 978-2-930229-98-0. [Online version International Diabetes Federation]. Available from: https://www.diabetesatlas.org or https://diabetesatlas.org/idfawp/resource-files/2021/07/IDF_Atlas_10th_Edition_2021.pdf.  Back to cited text no. 36
Anjana RM, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R, et al; ICMR–INDIAB Collaborative Study Group. Prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: Phase I results of the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study. Diabetologia 2011;54:3022-7.  Back to cited text no. 37
Mohan V, Sandeep S, Deepa R, Shah B, Varghese C Epidemiology of type 2 diabetes: Indian scenario. Indian J Med Res 2007;125:217-30.  Back to cited text no. 38
Gupta MK, Raghav P, Tanvir T, Gautam V, Mehto A, Choudhary Y, et al. Recalibrating the non-communicable diseases risk prediction tools for the rural population of western India. BMC Public Health 2022;22:376.  Back to cited text no. 39
Mohan V, Gokulakrishnan K, Deepa R, Shanthirani CS, Datta M Association of physical inactivity with components of metabolic syndrome and coronary artery disease—The Chennai Urban Population Study (CUPS no. 15). Diabet Med 2005;22:1206-11.  Back to cited text no. 40
Mohan V, Shanthi Rani CS, Amutha A, Dhulipala S, Anjana RM, Parathasarathy B, et al. Clinical profile of long-term survivors and nonsurvivors with type 2 diabetes. Diabetes Care 2013;36:2190-7.  Back to cited text no. 41
Khan MM, Sonkar GK, Alam R, Mehrotra S, Khan MS, Kumar A, et al. Validity of Indian Diabetes Risk Score and its association with body mass index and glycosylated hemoglobin for screening of diabetes in and around areas of Lucknow. J Family Med Prim Care 2017;6:366-73.  Back to cited text no. 42
[PUBMED]  [Full text]  
Khan MM, Sonkar GK, Singh S, Sonkar SK Importance of the Madras Diabetes Research Foundation-Indian Diabetes Risk Score (MDRF-IDRS) for mass screening of type 2 diabetes and its complications at primary health care centers of North India. Int J Diabetes Dev Ctries 2019;39:419-25. doi: 10.1007/s13410-018-0710-6.  Back to cited text no. 43
Krishnaveni GV, Hill JC, Veena SR, Leary SD, Saperia J, Chachyamma KJ, et al. Truncal adiposity is present at birth and in early childhood in South Indian children. Indian Pediatr 2005;42:527-38.  Back to cited text no. 44
Misra A, Vikram NK, Arya S, Pandey RM, Dhingra V, Chatterjee A, et al. High prevalence of insulin resistance in post-pubertal Asian Indian children is associated with adverse truncal body fat pattern in, abdominal adiposity and excess body fat. Int J Obes Relat Metab Disord 2004; 28:1217-26.  Back to cited text no. 45
Mohan V, Ravikumar R, Poongothai S, Amutha A, Sowmya S, Karkhuzali K, et al. A single-center, open, comparative study of the effect of using self-monitoring of blood glucose to guide therapy on preclinical atherosclerotic markers in type 2 diabetic subjects. J Diabetes Sci Technol 2010;4:942-8.  Back to cited text no. 46
Shah A, Kanaya AM Diabetes and associated complications in the South Asian population. Curr Cardiol Rep 2014;16:476.  Back to cited text no. 47
Ohman-Hanson RA, Cree-Green M, Kelsey MM, Bessesen DH, Sharp TA, Pyle L, et al. Ethnic and sex differences in adiponectin: From childhood to adulthood. J Clin Endocrinol Metab 2016;101:4808-15.  Back to cited text no. 48
Lewitt MS, Baker JS Relationship between abdominal adiposity, cardiovascular fitness, and biomarkers of cardiovascular risk in British adolescents. J Sport Health Sci 2020;9:634-44.  Back to cited text no. 49
Gokulakrishnan K, Aravindhan V, Amutha A, Abhijit S, Ranjani H, Anjana RM, et al. Serum adiponectin helps to differentiate type 1 and type 2 diabetes among young Asian Indians. Diabetes Technol Ther 2013;15:696-702.  Back to cited text no. 50
Senkus KE, Crowe-White KM, Bolland AC, Locher JL, Ard JD Changes in adiponectin: leptin ratio among older adults with obesity following a 12-month exercise and diet intervention. Nutr Diabetes 2022;12:30.  Back to cited text no. 51
Ebong IA, Wilson MD, Appiah D, Michos ED, Racette SB, Villablanca A, et al. Relationship between age at menopause, obesity, and incident heart failure: The atherosclerosis risk in communities study. J Am Heart Assoc 2022;11:e024461.  Back to cited text no. 52
Yasuda Y, Miyake N, Matsuoka H, Sugihara S Adiponectin, ALT and family history as critical markers for the development of type 2 diabetes in obese Japanese children. Endocrinol Diabetes Metab 2021;4:e00178.  Back to cited text no. 53
Bose KS, Gupta SK, Vyas P Adipocytokine levels in genetically high risk for type 2 diabetes in the Indian population: A cross-sectional study. Exp Diabetes Res 2012;2012:386524.  Back to cited text no. 54
Powell-Wiley TM, Poirier P, Burke LE, Després JP, Gordon-Larsen P, Lavie CJ, et al; American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Epidemiology and Prevention; and Stroke Council. Obesity and cardiovascular disease: A scientific statement from the American Heart Association. Circulation 2021;143:e984-e1010.  Back to cited text no. 55
Deepa M, Farooq S, Deepa R, Manjula D, Mohan V Prevalence and significance of generalized and central body obesity in an urban Asian Indian population in Chennai, India (CURES: 47). Eur J Clin Nutr 2009;63:259-67.  Back to cited text no. 56
Siddiqui MK, Anjana RM, Dawed AY, Martoeau C, Srinivasan S, Saravanan J, et al. Young-onset diabetes in Asian Indians is associated with lower measured and genetically determined beta cell function. Diabetologia 2022;65:973-83.  Back to cited text no. 57
Chait A, den Hartigh LJ Adipose tissue distribution, inflammation and its metabolic consequences, including diabetes and cardiovascular disease. Front Cardiovasc Med 2020;7:22.  Back to cited text no. 58
Khan MM, Sonkar GK, Alam R, Mehrotra S, Khan MS, Sonkar SK et al. Effect of age and body mass index on various clinical and anthropometric parameters of type 2 diabetic patients: A case–control study. Int J Health Sci Res 2016;6:132-42.  Back to cited text no. 59
Gupta S, Kapoor S Optimal cut-off values of anthropometric markers to predict hypertension in north Indian population. J Commun Health 2011;37:441-7.  Back to cited text no. 60
Pradeepa R, Prabu AV, Jebarani S, Subhashini S, Mohan V Use of a large diabetes electronic medical record system in India: Clinical and research applications. J Diabetes Sci Technol 2011;5:543-52.  Back to cited text no. 61
Lee DH, Lim JA, Kim JH, Kwak SH, Choi SH, Jang HC Longitudinal changes of high molecular weight adiponectin are associated with postpartum development of type 2 diabetes mellitus in patients with gestational diabetes mellitus. Endocrinol Metab (Seoul) 2021;36:114-22.  Back to cited text no. 62
Sirico F, Bianco A, D’Alicandro G, Castaldo C, Montagnani S, Spera R, et al. Effects of physical exercise on adiponectin, leptin, and inflammatory markers in childhood obesity: Systematic review and meta-analysis. Child Obes 2018;14:207-17.  Back to cited text no. 63
Otu LI, Otu A Adiponectin and the control of metabolic dysfunction: Is exercise the magic bullet? Front Physiol 2021;12:651732.  Back to cited text no. 64
Humińska-Lisowska K, Mieszkowski J, Kochanowicz A, Bojarczuk A, Niespodziński B, Brzezińska P, et al. Implications of adipose tissue content for changes in serum levels of exercise-induced adipokines: A quasi-experimental study. Int J Environ Res Public Health 2022;19:8782. doi: 10.3390/ijerph19148782.  Back to cited text no. 65
Becic T, Studenik C, Hoffmann G Exercise increases adiponectin and reduces leptin levels in prediabetic and diabetic individuals: Systematic review and meta-analysis of randomized controlled trials. Med Sci (Basel) 2018;6:97. doi: 10.3390/medsci6040097.  Back to cited text no. 66
O’Leary VB, Jorett AE, Marchetti CM, Gonzalez F, Phillips SA, Ciaraldi TP, et al. Enhanced adiponectin multimer ratio and skeletal muscle adiponectin receptor expression following exercise training and diet in older insulin-resistant adults. Am J Physiol Endocrinol Metab 2007;293:E421-7.  Back to cited text no. 67
Nishida Y, Higaki Y, Taguchi N, Hara M, Nakamura K, Nanri H, et al. Intensity-specific and modified effects of physical activity on serum adiponectin in a middle-aged population. J Endocr Soc 2019;3:13-26.  Back to cited text no. 68
Mohan V, Radhika G, Sathya RM, Tamil SR, Ganesan A, Sudha V Dietary carbohydrates, glycaemic load, food groups and newly detected type 2 diabetes among urban Asian Indian population in Chennai, India (Chennai Urban Rural Epidemiology Study 59). Br J Nutr 2009;102:1498-506.  Back to cited text no. 69
Malik VS, Hu FB The role of sugar-sweetened beverages in the global epidemics of obesity and chronic diseases. Nat Rev Endocrinol 2022;18:205-18.  Back to cited text no. 70
Anjana RM, Pradeepa R, Das AK, Deepa M, Bhansali A, Joshi SR, et al. Physical activity and inactivity patterns in India—Results from the ICMR-INDIAB study (Phase-1) [ICMR-INDIAB-5]. Int J Behav Nutr Phys Activity 2014;11:26.  Back to cited text no. 71
Podder V, Nagarathna R, Anand A, Patil SS, Singh AK, Nagendra HR Physical activity patterns in India stratified by zones, age, region, BMI and implications for COVID-19: A nationwide study. Ann Neurosci 2020;27:193-203.  Back to cited text no. 72
Burhans MS, Hagman DK, Kuzma JN, Schmidt KA, Kratz M Contribution of adipose tissue inflammation to the development of type 2 diabetes mellitus. Compr Physiol 2018;9:1-58.  Back to cited text no. 73
Meshkani R, Vakili S Tissue resident macrophages: Key players in the pathogenesis of type 2 diabetes and its complications. Clin Chim Acta 2016;462:77-89.  Back to cited text no. 74
Rønn PF, Andersen GS, Lauritzen T, Christensen DL, Aadahl M, Carstensen B, et al. Abdominal visceral and subcutaneous adipose tissue and associations with cardiometabolic risk in Inuit, Africans and Europeans: A cross-sectional study. BMJ Open 2020;10:e038071.  Back to cited text no. 75
Sulistyoningrum DC, Gasevic D, Lear SA, Ho J, Mente A, Devlin AM Total and high molecular weight adiponectin and ethnic-specific differences in adiposity and insulin resistance: A cross-sectional study. Cardiovasc Diabetol 2013;12:170.  Back to cited text no. 76
Karimi H, Nezhadali M, Hedayati M, Mahdavi M, Sheikholeslami S The impact of adiponectin gene polymorphisms on the insulin resistance index in patients with diabetes and newly diagnosed type 2 diabetes. Int J Diabetes Metab 2019;25:106-12.  Back to cited text no. 77
Mente A, Razak F, Blankenberg S, Vuksan V, Davis AD, Miller R, et al; Study of the Health Assessment and Risk Evaluation; Study of the Health Assessment and Risk Evaluation in Aboriginal Peoples Investigators. Ethnic variation in adiponectin and leptin levels and their association with adiposity and insulin resistance. Diabetes Care 2010;33:1629-34.  Back to cited text no. 78
Anjana RM, Baskar V, Nair AT, Jebarani S, Siddiqui MK, Pradeepa R, et al. Novel subgroups of type 2 diabetes and their association with microvascular outcomes in an Asian Indian population: A data-driven cluster analysis: The INSPIRED study. BMJ Open Diabetes Res Care 2020;8:e001506. doi:10.1136/ bmjdrc-2020-001506  Back to cited text no. 79
Mohan V, Shanthirani CS, Deepa M, Deepa R, Unnikrishnan RI, Datta M Mortality rates due to diabetes in a selected urban South Indian population—The Chennai Urban Population Study [CUPS–16]. J Assoc Physicians India 2006;54:113-7.  Back to cited text no. 80
Prakash J, Mittal B, Awasthi S, Srivastava N Association of adiponectin gene polymorphism with adiponectin levels and risk for insulin resistance. Int J Prew Med 2015;6:31.  Back to cited text no. 81
Ortiz-Huidobro RI, Velasco M, Larqué C, Escalona R, Hiriart M Molecular insulin actions are sexually dimorphic in lipid metabolism. Front Endocrinol (Lausanne) 2021;12:690484.  Back to cited text no. 82
Paley CA, Johnson MI Abdominal obesity and metabolic syndrome: Exercise as medicine? BMC Sports Sci Med Rehabil 2018;10:7.  Back to cited text no. 83
Millar SR, Harrington JM, Perry IJ, Phillips CM Associations between a protective lifestyle behaviour score and biomarkers of chronic low-grade inflammation: A cross-sectional analysis in middle-to-older aged adults. Int J Obes (Lond) 2022;46:476-85.  Back to cited text no. 84
Calcaterra V, Vandoni M, Rossi V, Berardo C, Grazi R, Cordaro E, et al. Use of physical activity and exercise to reduce inflammation in children and adolescents with obesity. Int J Environ Res Public Health 2022;19:6908.  Back to cited text no. 85
Monti LD, Genzano CB, Fontana B, Galluccio E, Spadoni S, Magistro A, et al. Association between new markers of cardiovascular risk and hepatic insulin resistance in those at high risk of developing type 2 diabetes. Endocrine 2022;75:409-17.  Back to cited text no. 86
Fowler JR, Tucker LA, Bailey BW, LeCheminant JD Physical activity and insulin resistance in 6,500 NHANES adults: The role of abdominal obesity. J Obes 2020;2020:3848256.  Back to cited text no. 87
Cheng YH, Tsao YC, Tzeng IS, Chuang HH, Li WC, Tung TH, et al. Body mass index and waist circumference are better predictors of insulin resistance than total body fat percentage in middle-aged and elderly Taiwanese. Medicine (Baltimore) 2017;96:e8126.  Back to cited text no. 88
Firouzi SA, Tucker LA, LeCheminant JD, Bailey BW Sagittal abdominal diameter, waist circumference, and BMI as predictors of multiple measures of glucose metabolism: An NHANES investigation of US adults. J Diabetes Res 2017;2018:14 (Article ID 3604108).  Back to cited text no. 89
Annesi JJ Effects of increased physical activity/exercise on long-term losses in weight and waist circumference: Serial mediation from changes in exercise-related to eating-related self-regulation. Int J Behav Med 2022. doi: 10.1007/s12529-022-10106-5.  Back to cited text no. 90
Laurens C, Bergouignan A, Moro C Exercise-released myokines in the control of energy metabolism. Front Physiol 2020;11:91.  Back to cited text no. 91
carneiro MAS, Oliveira-Júnior G, Castro-E-Souza P, Oliveira AA, Nunes PR, Izquierdo M, et al. Impact of exercise intervention-based changes on physical function biomarkers in older adults after hospital discharge: A systematic review with meta-analysis of randomized clinical trials. Ageing Res Rev 2022;80:101673.  Back to cited text no. 92
Bushra S, Al-Sadeq DW, Bari R, Sahara A, Fadel A, Rizk N Adiponectin ameliorates hyperglycemia-induced retinal endothelial dysfunction, highlighting pathways, regulators, and networks. J Inflamm Res 2022;15:3135-66.  Back to cited text no. 93
Anjana RM, Unnikrishnan R, Deepa M, Venkatesan U, Pradeepa R, Joshi S, et al; ICMR-INDIAB Collaborators. Achievement of guideline recommended diabetes treatment targets and health habits in people with self-reported diabetes in India (ICMR-INDIAB-13): A national cross-sectional study. Lancet Diabetes Endocrinol 2022;10:430-41.  Back to cited text no. 94
Manne-Goehler J The ABC targets of diabetes in India. Lancet Diabetes Endocrinol 2022;10:378-9.  Back to cited text no. 95
Unnikrishnan AG, Sahay RK, Phadke U, Sharma SK, Shah P, Shukla R, et al. Cardiovascular risk in newly diagnosed type 2 diabetes patients in India. PLoS One 2022;17:e0263619.  Back to cited text no. 96


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