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Adiponectin, risk of coronary heart disease and correlations with cardiovascular risk markers
Dietrich Rothenbacher1, Hermann Brenner, Winfried März
1Department of Epidemiology, The German Centre for Research on Ageing, University of Heidelberg, Germany.
Insights
Lower serum adiponectin (a protein) levels are linked to increased coronary heart disease (CHD) risk. High adiponectin may offer protection, partly through its influence on HDL cholesterol metabolism.
Area of Science:
- Cardiovascular Disease Research
- Endocrinology
- Biomarker Discovery
Background:
- Serum adiponectin levels are increasingly recognized as potential biomarkers for cardiovascular health.
- Established risk factors for coronary heart disease (CHD) include lifestyle, genetic, and metabolic parameters.
- Understanding novel associations can refine risk prediction and therapeutic strategies.
Purpose of the Study:
- To investigate the association between serum adiponectin concentrations and the risk of developing coronary heart disease (CHD).
- To examine how adiponectin levels correlate with known sociodemographic and laboratory markers of CHD risk.
- To adjust for established risk factors to clarify adiponectin's independent role.
Main Methods:
- A case-control study involving 312 patients with confirmed stable CHD and 476 matched controls.
- Measurement of serum adiponectin concentrations, inflammation markers, hemostasis markers, and a comprehensive lipid profile.
- Statistical analysis including logistic regression to calculate odds ratios (OR) for CHD risk across adiponectin levels, with covariate adjustments.
Main Results:
- Patients with CHD exhibited significantly lower median serum adiponectin concentrations compared to controls in both men and women.
- Adiponectin levels showed strong correlations with lipoproteins, particularly HDL-cholesterol (HDL-C), and moderate correlations with inflammatory markers.
- Higher adiponectin levels were associated with a reduced odds ratio for CHD (OR=0.52), an effect substantially diminished after adjusting for HDL-C.
Conclusions:
- Serum adiponectin concentrations appear to play a significant role in the pathogenesis of coronary heart disease.
- The potential cardioprotective effect of elevated adiponectin may be partly mediated by its influence on lipoprotein metabolism, especially HDL.
- Adiponectin's strong association with HDL-C highlights the interplay between these factors in cardiovascular risk.
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.
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