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This version published online on August 2, 2005
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2005-0825
A more recent version of this article appeared on October 1, 2005
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Submitted on April 14, 2005
Accepted on July 22, 2005

Plasma adiponectin levels are associated with insulin resistance but do not predict future risk of coronary heart disease in women

Debbie A Lawlor*, George Davey Smith, Shah Ebrahim, Claire Thompson, and Naveed Sattar

Department of Social Medicine, University of Bristol, UK; Division of Cardiovascular and Medical Sciences, University of Glasgow

* To whom correspondence should be addressed. E-mail: d.a.lawlor{at}bristol.ac.uk.

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 - To assess the association between adiponectin and incident CHD risk in the British Women's Heart and Health Study (BWHHS).

Design - A prospective (4 yr) case (n = 167) control (n = 334) study nested within the 4,286 women in BWHHS

Setting - Primary care

Participants - Women (n = 4286) randomly selected from 23 British towns between 1999 and 2001 and who were aged 60-79 yr at baseline

Main Outcome Measures - Association of adiponectin with CHD risk factors and incident CHD events.

Results - Among both cases and controls adiponectin positively correlated with age and HDL-C and inversely correlated with waist to hip ratio, fasting insulin, fasing glucose, HOMA scores, CRP and triglycerides. However, despite adequate power and these associations with CHD risk factors, adiponectin did not predict CHD events in unadjusted or adjusted analyses: relative risk ratio for a doubling of adiponectin was 0.93 (95% CI: 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. Further, prospective studies are required to determine whether there is a true sex difference in the effect of adiponectin on CHD.
Key words: coronary heart disease • adiponectin • insulin resistance




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