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Submitted on April 19, 2006
Accepted on August 8, 2006
Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University Graz, Austria (S.P., H.M., B.T., W.M.); LURIC Study non-profit LLC, Freiburg, Germany (B.W.,U.S.); Division of Endocrinology and Diabetes, Graduate School Molecular Endocrinology and Diabetes Ulm University, Germany (B.O.B.); Synlab Centre of Laboratory Diagnostics, Heidelberg, Germany (W.M.)
* To whom correspondence should be addressed. E-mail: maerz{at}synlab.de.
Context: The adipokine adiponectin has been suggested to protect from coronary artery disease (CAD). However, studies addressing the association between adiponectin and mortality are sparse.
Objective: To elucidate the relationship between adiponectin and mortality.
Design, Setting and Participants: Adiponectin was determined in 2473 persons with and 673 persons without angiographic CAD. During a mean follow-up period of 5.45 yr, 427 persons with CAD and 55 persons without CAD died.
Main Outcome Measure: Hazard ratios for mortality according to adiponectin levels.
Results: Adiponectin was positively related to female gender, age, LDL cholesterol, HDL cholesterol, homocysteine, and N terminal pro-B-type natriuretic peptide. It was inversely related to glomerular filtration rate, body mass index and triglycerides and was low in diabetes mellitus and CAD. An increase of one SD in adiponectin was associated with unadjusted and fully adjusted hazard ratios for death from any cause of 1.31 (95% confidence interval [CI] 1.20-1.42) and 1.22 (95% CI 1.12-1.34), and for death from cardiovascular causes of 1.32 (95% CI 1.19-1.45) and 1.23 (95% CI 1.11-1.37), respectively. In angiographic CAD, stable CAD and unstable CAD, the predictive value of adiponectin was similar to that in the entire cohort, but it did not attain statistical significance in persons without angiographic CAD. Adiponectin was also positively related to the risk of death from non-cardiovascular causes.
Conclusions: Despite the common view about adiponectin as a protective molecule in cardiovascular disease high adiponectin independently predicts all-cause, cardiovascular and non-cardiovascular mortality in individuals with CAD.
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