[Adiponectin: an emerging cardiovascular risk factor. The REFERENCE Study]

Emerging cardiovascular (CV) risk factors such as adiponectin, glycosilated hemoglobin, waist circumference and the high-sensitivity C-reactive protein (hsCRP) level can aid CV risk stratification. It has been shown that classic factors alone are not sufficient to explain CV risk fully. The adiponectin level has been linked to insulin resistance, dyslipidemia and coronary artery disease. This study investigated how the levels of adiponectin and other emerging risk factors are related to CV events in the Spanish population.

This cross-sectional study involved 999 patients. They were divided into cases, who had experienced a first CV event in the 3 months prior to the study, and controls. Anthropometric and laboratory parameters recorded both after the event and 3 years before the study started were obtained.

Both a low adiponectin level and a high hsCRP level were associated with the occurrence of a CV event. In addition, obesity and a triglyceride level > or = 150 mg/dL, both observed 3 years before the study, were also associated with the occurrence of an event. There was an inverse relationship between the plasma adiponectin level and waist circumference. Multivariate analysis identified the following significant variables: hsCRP level, a family history of early CV disease and the high-density lipoprotein cholesterol (HDL-C) level 3 years earlier.

A low adiponectin level is associated with abdominal obesity. Emergent risk factors do not improve the predictive ability of the Systematic Coronary Risk Evaluation (SCORE) algorithm (which includes total cholesterol, HDL-C, blood pressure and smoking). Further studies evaluating their contribution are needed.