This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kizer, J. R. Articles by Gottdiener, J. S. Search for Related Content PubMed PubMed Citation Articles by Kizer, J. R. Articles by Gottdiener, J. S. Related Collections Cardiovascular Endocrinology Metabolism

Adiponectin and Risk of Coronary Heart Disease in Older Men and Women

Departments of Medicine and Public Health (J.R.K.), Weill Medical College of Cornell University, New York, New York 10065; Division of Endocrinology (J.I.B.), Kaiser Permanente of Georgia, and Division of Endocrinology, Emory University School of Medicine, Atlanta, Georgia 30322; Department of Epidemiology (L.H.K.), University of Pittsburgh, Pittsburgh, Pennsylvania 15260; and Division of Cardiology (J.S.G.), University of Maryland Medical Center, Baltimore, Maryland 21201

Address all correspondence and requests for reprints to: Dr. Jorge Kizer, Box 222, Weill Cornell Medical Center, 525 E. 68th Street, New York, New York 10065. E-mail: jok2007{at}med.cornell.edu.

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 = 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 = 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 = 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.

This article has been cited by other articles:

				K. Karastergiou, V. Mohamed-Ali, M. Jahangiri, and J.-C. Kaski Review: Adiponectin for prediction of cardiovascular risk? The British Journal of Diabetes & Vascular Disease, July 1, 2009; 9(4): 150 - 154. [Abstract] [PDF]