Adiponectin: An Emerging Cardiovascular Risk Factor. The REFERENCE Study (original) (raw)
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Association between plasma adiponectin levels and unstable coronary syndromes
European Heart Journal, 2007
Obesity is a risk factor for an acute coronary syndrome (ACS). The association between elevated body mass index (BMI) and ACS is independent of most traditional risk factors, suggesting a possible contribution of other body fat-related mediators. This study evaluated the association between adiponectin and ACS. Four hundred and ninety-nine patients undergoing coronary angiography were divided into a subgroup without (n = 331) and with ACS (n = 168). In multiple regression analysis, higher adiponectin levels were independently associated with a lower risk of ACS [odds ratio (OR) = 0.61; 95% CIs: 0.46-0.81; P < 0.001]. In contrast, a higher BMI, a history of myocardial infarction, C-reactive protein, and angiographic coronary artery disease severity were all associated with a higher risk. The greatest increase in risk for ACS was seen at adiponectin levels < or = 5.5 microg/mL. Higher plasma adiponectin levels are independently associated with a lower risk of ACS.
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.
Atherosclerosis, 2008
Familial hypercholesterolemia (FH) is characterized by increased risk for premature coronary artery disease (CAD). This risk is exacerbated in the presence of abdominal obesity and insulin resistance. Low adiponectin is part of the clustering of metabolic abnormalities associated with abdominal obesity and insulin resistance. The present study, therefore, aims to examine the relationship between plasma adiponectin and age at CAD diagnosis in FH patients.
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...
Atherosclerosis, 2011
Objective: Our aim was to determine whether plasma adiponectin levels were an independent predictor of coronary heart disease (CHD) risk. Methods and results: Plasma adiponectin levels were measured in 3188 male and female participants from cycle 6 of the Framingham offspring Study (mean age: 57 years in both men and women; BMI: 28.5 kg/m 2 in men and 27.3 kg/m 2 in women), using a novel fully automated assay. Plasma adiponectin levels (median [25th percentile, 75th percentile]) were significantly higher in female than in male CHDfree subjects (14.8 [10.7,20.5] g/ml versus 9.0 [7.0,12.2] g/ml, p < 0.001). Participants were followed for a mean of 7.5 years. After adjustment for age, BMI, smoking status, systolic blood pressure, treatment for hypertension, diabetes, use of cholesterol-lowering medication, total cholesterol level, high-density lipoprotein cholesterol level, and C-reactive protein levels, a higher plasma adiponectin level was a significant predictor of lower risk of future CHD events (n = 117) in men (HR 0.49, p < 0.0022). A similar trend was observed in women, but was no longer significant after multivariate adjustments. Conclusions: Our data indicate that plasma adiponectin levels are an independent predictor of CHD in Caucasian men initially free of CHD.
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.
Plasma Adiponectin for Prediction of Cardiovascular Events and Mortality in High-Risk Patients
The Journal of Clinical Endocrinology & Metabolism, 2008
The prognostic value of plasma levels of adiponectin, an adipocytokine with antiatherogenic, antiinflammatory, and insulin-sensitizing effects, is contentious. Objective: The objective of the study was to investigate whether plasma adiponectin levels predict cardiovascular (CV) events and mortality in high-risk coronary artery disease (CAD) patients. Design, Setting, Participants, and Main Outcome Measure: We measured plasma adiponectin and examined its impact on the incidence of CV deaths and events at follow-up in the context of all potentially relevant background covariates in 712 high-risk patients of the Genetic and ENvironmental factors in Coronary Atherosclerosis study who underwent coronary angiography for suspected CAD. Based on the population plasma adiponectin median (6.38 g/ml, interquartile range 4.2-10.2), we split the patients in a high-and a low-plasma adiponectin subgroup. After a median follow-up of 3.8 years (interquartile range 3.3-4.3 yr), outcome data were obtained in 100% of the patients and 45 CV deaths (6.4%) were recorded. Kaplan-Meier analysis unexpectedly showed a higher CV death rate in high-plasma adiponectin than low-plasma adiponectin patients. By contrast, multivariate Cox regression analysis, in which potential confounders, including ongoing medical treatment, were considered, showed no impact of plasma adiponectin on CV death. Similar negative results were obtained using the propensity score that considered all relevant covariables and medical treatment rate, which differed between the high-and low-plasma adiponectin group. Conclusions: In high-risk CAD patients, plasma adiponectin above the median (6.38 g/ml) implies a paradoxical higher risk of CV death. However, when relevant covariates that differ between highand low-plasma adiponectin groups are considered, this association wanes, indicating that the clustering of plasma adiponectin with other covariates can abolish its impact on CV prognosis.
Relationship of Plasma Adiponectin and Waist-hip Ratio with Coronary Artery Disease
Medical Archives, 2016
Background: This study aimed to investigate correlation between adiponectin and waisthip-ratio with severity of coronary artery disease (CAD). There is uncertainty about the association between circulating concentrations of adiponectin and CAD. Methods: We enrolled eighty-two consecutive patients undergoing non-urgent coronary angiography for CAD survey. According to the angiography results, the patients were divided into two groups in 1:1 ratio patients admitted with a diagnosis of CAD and non-CAD. We conducted hospital based research, involving study group with documented angiographically CAD, and control group without evidence of CAD. Angiograms were also quantified for the extent and severity of CAD by the Gensini scoring system. We measured baseline adiponectin levels in stored serum samples of all patients, anthropometric and biochemical risk factors were assessed in both groups. Results: The presence of CAD was associated with current smoking, male gender, waist-hip ratio (WHR) and left ventricular ejection fraction (LVEF). Baseline adiponectin concentrations correlated significantly in terms of the lipid parameters, positively with HDL cholesterol concentrations (r=0.327, P=0.028, P<0.05) and serum triglyceride concentrations were correlated negatively (r=-0.513, P<0.001). No significant difference between median adiponectin levels at baseline was observed between cases and controls. Conclusion: There is a significant positive correlation between waist-hip ratio and presence and severity of coronary artery disease. In conclusion, there is a significant positive correlation between adiponectin and Gensini score among Kosovar patients.