Aims: We investigated the association of serum adiponectin concentrations with the risk of coronary heart disease (CHD) after careful adjustment for other established risk factors. In addition, we investigated the association between adiponectin levels and established sociodemographic and laboratory risk markers for CHD.
Methods and results: Three hundred and twelve patients aged 40-68 with angiographically confirmed stable CHD and 476 age- and gender-matched controls were included in this case-control study. Adiponectin serum concentrations (adiponectin, R&D Systems, Wiesbaden, Germany), markers of inflammation and haemostasis, and an extensive lipid profile were determined. Adiponectin serum concentrations were lower in CHD patients when compared with age- and gender-matched controls, both in men (median 4.95 vs. 5.58 micromol/L, P=0.004) and in women (median 9.64 vs. 11.60 micromol/L, P=0.018). Adiponectin was strongly correlated with lipoproteins and apolipoproteins, in particular HDL-cholesterol (HDL-C), and to a lesser degree with markers of inflammation such as C-reactive protein, IL-6, or markers of coagulation or fibrinolysis. When compared with subjects with adiponectin serum concentrations in the lower quintile, the OR for CHD was 0.52 (95% CI 0.28-0.95) in the upper one after adjustment for covariates (P<0.007 for trend). After additional adjustment for HDL-C the association was strongly reduced, reflecting the close association between adiponectin and HDL-C.
Conclusion: Adiponectin serum concentrations may have an important role in the development of CHD. The protective effect of high serum concentration may partly be mediated by effects on the metabolism of lipoproteins, especially on the metabolism of HDL.