Adiponectin: An independent risk factor for coronary heart disease in men in the Framingham offspring Study (original) (raw)
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Adiponectin and Risk of Coronary Heart Disease in Older Men and Women
The Journal of Clinical Endocrinology and Metabolism, 2008
Context: Despite established insulin-sensitizing and antiatherogenic preclinical effects, epidemiological investigations of adiponectin have yielded conflicting findings, and its relationship with coronary heart disease (CHD) remains uncertain. Objective: Our objective was to investigate the relationship between adiponectin and CHD in older adults. Design, Setting, and Participants: This was a case-control study (n ϭ 1386) nested within the population-based Cardiovascular Health Study from 1992-2001. Controls were frequency-matched to cases by age, sex, race, subclinical cardiovascular disease, and center. Main Outcome Measures: Incident CHD was defined as angina pectoris, percutaneous or surgical revascularization, nonfatal myocardial infarction (MI), or CHD death. A more restrictive CHD endpoint was limited to nonfatal MI and CHD death. Results: Adiponectin exhibited significant negative correlations with baseline adiposity, insulin resistance, dyslipidemia, inflammatory markers, and leptin. After controlling for matching factors, adjustment for waist to hip ratio, hypertension, smoking, alcohol, low-density lipoprotein cholesterol, creatinine, and leptin revealed a modestly increased risk of incident CHD with adiponectin concentrations at the upper end [odds ratio ϭ 1.37 (quintile 5 vs. 1-4), 95% confidence interval 1.02-1.84]. This association was stronger when the outcome was limited to nonfatal MI and fatal CHD (odds ratio ϭ 1.69, 95% confidence interval 1.23-2.32). The findings were not influenced by additional adjustment for weight change, health status, or cystatin C, nor were they abolished by adjustment for potential mediators. Conclusions: This study shows an association between adiponectin and increased risk of first-ever CHD in older adults. Further research is needed to elucidate the basis for the concurrent beneficial and detrimental aspects of this relationship, and under what circumstances one or the other may predominate.
Atherosclerosis, 2008
Objective: Adiponectin has anti-atherogenic properties and low circulating adiponectin has been linked to coronary atherosclerosis. Yet, there is considerable evidence that the high-molecular weight (HMW) complex of adiponectin is the major active form of this adipokine. We therefore investigated whether HMW adiponectin is associated with the extent of coronary artery disease (CAD) in men. Research design and methods: Associations among CAD, HMW adiponectin and the HMW/total-adiponectin ratio were assessed in 240 male patients undergoing elective coronary angiography. Total adiponectin and HMW adiponectin was measured by enzyme-linked immunosorbent assay and serum levels were correlated with defined coronary scores and established cardiovascular risk factors. Results: We found significant inverse correlations between angiographic scores and HMW adiponectin [Extent Score (ES): r = −0.39; Gensini Score (GS): r = −0.35; and Severity Score (SS): r = −0.40, all P < 0.001], and the HMW/total-adiponectin ratio (ES: r = −0.49; GS: r = −0.46; SS: r = −0.46; all P < 0.001).
Association of Adiponectin with Coronary Heart Disease and Mortality: The Rancho Bernardo Study
American Journal of Epidemiology, 2006
Hypoadiponectinemia has been implicated in the development of obesity-related conditions, including dyslipidemia and coronary heart disease (CHD). In this study, the authors examined the association of adiponectin with CHD prevalence, incidence, and mortality among 1,513 community-dwelling men and women aged 50-91 years who were followed from 1984-1987 through 2004. In cross-sectional analyses, adiponectin concentrations were positively related to female sex, age, and high density lipoprotein cholesterol level and inversely related to waist girth, triglyceride level, and fasting plasma glucose level (all p's < 0.001). Adiponectin levels in the highest sex-specific quintile, as compared with the lowest, were associated with 44% decreased odds of prevalent CHD (p for trend ¼ 0.03); adjustment for high density lipoprotein cholesterol and/or triglycerides eliminated this association. In 20-year prospective analyses, higher adiponectin concentrations predicted reduced risk of nonfatal myocardial infarction in men only; adiponectin was not associated with fatal incident CHD events or 20-year CHD mortality (n ¼ 215 deaths) in either sex. Adiponectin levels in the highest sex-specific quintile, as compared with lower levels, were associated with almost 40% increased risks of cardiovascular disease death (n ¼ 441) and death from all causes (n ¼ 925), independent of age, sex, waist girth, lipid levels, and glucose level (both p's < 0.001). These results suggest that use of adiponectin for cardiovascular disease risk stratification is premature. adiponectin; cardiovascular diseases; coronary disease; mortality Abbreviations: CHD, coronary heart disease; HDL, high density lipoprotein.
Archives of Iranian medicine, 2012
Adiponectin plays important roles in the endocrine and cardiovascular systems, in fat and carbohydrate metabolism, and inflammation. In this study the relationship between adiponectin levels with the presence and severity of coronary artery disease (CAD) is evaluated. This was a cross-sectional study that enrolled 213 persons who referred for coronary angiography. One cardiologist reported the results of each coronary angiography by using two scoring systems [number of vessel disease (usual method) and Gensini scoring system]. Then, the relationship between adiponectin levels with the presence and severity of CAD as well as predictive factors for CAD were evaluated. There was a significant negative association between mean serum adiponectin levels and presence of CAD (P = 0.04) after adjustment for all conventional risk factors for CAD. Also there was a significant negative correlation between serum adiponectin levels and severity of CAD based on the usual method for reporting coron...
Adiponectin: An Emerging Cardiovascular Risk Factor. The REFERENCE Study
Revista Española de Cardiología (English Edition), 2008
Emerging cardiovascular (CV) risk factors such as adiponectin, glycosilated hemoglobin, waist circumference and the high-sensitivity C-reactive protein (hsCRP) level can aid CV risk stratification. It has been shown that classic factors alone are not sufficient to explain CV risk fully. The adiponectin level has been linked to insulin resistance, dyslipidemia and coronary artery disease. This study investigated how the levels of adiponectin and other emerging risk factors are related to CV events in the Spanish population. This cross-sectional study involved 999 patients. They were divided into cases, who had experienced a first CV event in the 3 months prior to the study, and controls. Anthropometric and laboratory parameters recorded both after the event and 3 years before the study started were obtained. Both a low adiponectin level and a high hsCRP level were associated with the occurrence of a CV event. In addition, obesity and a triglyceride level &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 150 mg/dL, both observed 3 years before the study, were also associated with the occurrence of an event. There was an inverse relationship between the plasma adiponectin level and waist circumference. Multivariate analysis identified the following significant variables: hsCRP level, a family history of early CV disease and the high-density lipoprotein cholesterol (HDL-C) level 3 years earlier. A low adiponectin level is associated with abdominal obesity. Emergent risk factors do not improve the predictive ability of the Systematic Coronary Risk Evaluation (SCORE) algorithm (which includes total cholesterol, HDL-C, blood pressure and smoking). Further studies evaluating their contribution are needed.
Endocrine, 2017
Purpose: Adiponectin is an adipokine with anti-inflammatory and cardiovascular-protective properties. Existing epidemiological evidence is conflicting on the exact relationship between adiponectin and long-term cardiovascular disease (CVD) risk. Our aim was to prospectively assess whether circulating adiponectin is associated with long-term incident CVD. Methods: A population-based, prospective study in adults (>18 years) without previous CVD history (ATTICA study). Circulating total adiponectin levels were measured at baseline (2001-2002) in a sub-sample (n=531; women/men: 222/309; age: 40±11 years) of the ATTICA cohort and complete 10-year follow-up data were available in 366 of these participants (women/men: 154/212; age: 40±12 years). Results: After adjusting for multiple factors, including age, sex, body mass index, waist circumference, smoking, physical activity, Mediterranean diet adherence, hypertension, diabetes and hypercholesterolemia, our logistic regression analysis indicates that an increase in circulating total adiponectin levels by 1 unit was associated with 36% lower CVD risk (relative risk [RR]: 0.64, 95% confidence interval [CI]: 0.42-0.96; p=0.03). Further adjusting for interleukin-6 plasma levels had no significant impact (RR: 0.60, 95% CI: 0.38-0.94; p=0.03), while additional adjustment for circulating C-reactive protein (CRP) modestly attenuated this association (RR: 0.63, 95% CI: 0.40-0.99; p=0.046). Conclusions: In our study elevated circulating total adiponectin levels were associated with lower 10-year CVD risk in adults without previous CVD, independently of other established CVD risk factors. This association appeared to be modestly attenuated by CRP, yet was not mediated by interleukin-6 which is the main endocrine/circulating pro-inflammatory cytokine.
Implications of plasma concentrations of adiponectin in patients with coronary artery disease
Heart (British Cardiac Society), 2004
To investigate whether concentrations of plasma adiponectin constitute a significant coronary risk factor, with particular focus on the relation between plasma concentrations of adiponectin and the development of acute coronary syndrome (ACS). Plasma concentrations of adiponectin were measured in 123 patients with coronary artery disease (CAD) and in 17 control participants. Patients were divided into three groups according to condition type: acute myocardial infarction (AMI) group (n = 59), unstable angina pectoris (UAP) group (n = 28), and stable angina pectoris (SAP) group (n = 36). Plasma concentrations of adiponectin correlated negatively with body mass index (r = -0.18, p < 0.05), serum triglyceride (r = -0.25, p < 0.01), and fasting glucose concentrations (r = -0.21, p < 0.05), but correlated positively with age (r = 0.26, p < 0.01), high density lipoprotein cholesterol concentrations (r = 0.35, p < 0.01), and low density lipoprotein particle size (r = 0.37, p ...
Adiponectin and Future Coronary Heart Disease Events Among Men With Type 2 Diabetes
Diabetes, 2004
Adiponectin, predominantly synthesized in the adipose tissue, seems to have substantial anti-inflammatory properties and to be a major modulator of insulin resistance and dyslipidemia, mechanisms that are associated with an increased atherosclerotic risk in diabetic patients. However, it is unknown whether higher levels of adiponectin are associated with a reduced risk for coronary heart disease (CHD) among diabetic individuals. We investigated the association between plasma adiponectin levels and incidence of CHD among 745 men with confirmed type 2 diabetes in the Health Professionals Follow-up Study. Participants were aged 46 -81 years and were free of diagnosed cardiovascular disease at the time of blood draw in 1993/1994. During an average of 5 years of follow-up (3,980 person-years), we identified 89 incident cases of CHD (19 myocardial infarction and 70 coronary artery bypass surgery), confirmed by medical records. Levels of adiponectin were inversely associated with BMI and directly associated with age, alcohol intake, and duration of diabetes (P < 0.05). After adjustment for age, BMI, smoking, alcohol consumption, duration of diabetes, and other lifestyle factors, adiponectin was associated with a decreased risk for CHD events. The multivariate relative risk for CHD for a doubling of adiponectin was 0.71 (95% CI 0.53-0.95). Further adjustment for HDL cholesterol attenuated this association (0.78 [0.57-1.06]). The inverse association between adiponectin and CHD was consistent across strata of aspirin use, family history of myocardial infarction, alcohol consumption, insulin use, duration of diabetes, and levels of HbA 1c , triglycerides, C-reactive protein, and HDL cholesterol. Our study suggests that increased adiponectin levels are associated with a moderately decreased CHD risk in diabetic men. This association seems to be mediated in part by effects of adiponectin on HDL cholesterol levels.