Adiponectin: Identification, physiology and clinical relevance in metabolic and vascular disease

Adiponectin is the most abundant adipose-specific protein. Its expression is reduced in obesity, insulin resistance and type 2 diabetes, and plasma concentrations are inversely related to body weight, especially visceral adiposity. Adiponectin is also inversely associated with other traditional cardiovascular risk factors, such as blood pressure, low-density lipoprotein cholesterol and triglyceride levels, and is positively related to high-density lipoprotein cholesterol (HDL-C) levels. Recent research has indicated that adiponectin has anti-inflammatory, anti-atherogenic and antidiabetic properties. The ability of adiponectin to reduce insulin resistance in conjunction with its anti-inflammatory and anti-atherogenic properties makes this novel adipocytokine a promising therapeutic target, and agents that enhance adiponectin secretion or action have potential for treatment of metabolic and vascular disease. Current management strategies that may increase endogenous adiponectin production in humans include weight loss, soy protein and therapy with peroxisome proliferator-activating receptor gamma (PPARgamma) agonists.