Plasma Adiponectin Levels Are Associated with Insulin Resistance, But Do Not Predict Future Risk of Coronary Heart Disease in Women

Abstract

Context: Low adiponectin levels predict type 2 diabetes, and one prospective study in men reported its independent prediction of vascular events. Many observers thus already consider adiponectin to be a major part of the "common soil" underpinning diabetes and vascular disease.Objective: The objective of this study was to assess the association between adiponectin and incident coronary heart disease (CHD) risk in the British Women's Heart and Health Study.Design: This was a prospective (4 yr) case (n ϭ 167) control (n ϭ 334) study nested within the 4286 women in British Women's Heart and Health Study. Setting:The study was performed in a primary care setting. Participants:The study consisted of women (n ϭ 4286) randomly selected from 23 British towns between 1999 and 2001, who were 60 -79 yr of age at baseline. Main Outcome Measures:Association of adiponectin with CHD risk factors and incident CHD events were the main outcome measures.Results: Among both cases and controls, adiponectin positively correlated with age and high-density lipoprotein cholesterol and inversely correlated with waist to hip ratio, fasting insulin, fasting glucose, homeostasis model assessment of insulin resistance scores, C-reactive protein, and triglycerides. However, despite adequate power and these associations with CHD risk factors, adiponectin did not predict CHD events in unadjusted or adjusted analyses. The relative risk ratio for a doubling of adiponectin was 0.93 (95% confidence interval, 0.78, 1.11). Conclusions:It is premature to consider adiponectin as a root for vascular disease in women despite its association with insulin resistance and diabetes. Additional prospective studies are required to determine whether there is a true sex difference in the effect of adiponectin on CHD.

Associations of adiponectin with metabolic and vascular risk parameters in the British Regional Heart Study reveal stronger links to insulin resistance-related than to coronory heart disease risk-related parameters

“…Of the classical CHD risk factors, adiponectin did not associate with systolic blood pressure, cholesterol or fibrinogen, suggesting that adiponectin may play a more important role in insulin resistance and the development of diabetes. In line with this possibility, no significant association was seen between adiponectin and prevalent vascular disease, which is consistent with recent prospective case-control studies showing no association between adiponectin and CHD 20,22 and at variance with the first reported prospective study. 19 Adiponectin was strongly associated with obesity, but was associated with few other lifestyle characteristics associated with CHD or diabetes.…”

“…22,25,28,29,43 The associations between adiponectin and insulin sensitivity has been well established in animal and human models. 2,24 The strongest associations, however, were seen between adiponectin and triglycerides and HDL-cholesterol (components of the insulin resistance syndrome) and these relationships were independent of adiposity and insulin resistance as has been reported in other studies.…”

“…[11][12][13][14][15][16] Although an inverse association has been found between adiponectin and prevalent coronary heart disease (CHD) in crosssectional studies, 17,18 prospective studies have produced conflicting results. [19][20][21][22] It remains uncertain whether adiponectin is a critical factor in the 'common soil' 23 leading to both diabetes and cardiovascular disease.…”

Plasma adiponectin levels predict cardiovascular events in the observational Arita Cohort Study in Japan: the importance of the plasma adiponectin levels

“…The British Women's Heart and Health Study found no association between the plasma adiponectin level and new-onset CAD during 4 years of follow-up. 5 In older Dutch subjects, a high baseline plasma adiponectin level was associated with increased 15-year mortality. 6 In young survivors (o60 years of age) following a first myocardial infarction, however, a low plasma adiponectin level was associated with recurrent infarction.…”

Emerging Markers of Atherosclerosis Before and After Bariatric Surgery

“…In this context, it is suggested that hypoadiponectinemia would define by using sex and ethnic-specific levels. In addition, it remains inconclusive whether adiponectin levels can predict future risk of coronary heart disease in women [6,7]. Further study is necessary to clarify the association between adiponectin and a predictor of cardiovascular disease.…”