Gender differences in adiponectin levels among obese individuals and their association with cardiovascular disease

Obesity is one of the major risk factors for cardiovascular disease Adiponectin, an adipokine with cardioprotective effects, exhibits significant sex differences, with higher plasma levels observed in women. However, the mechanistic basis of this sex difference and its pathophysiological significance in obesity-related cardiovascular disease require further elucidation. This review systematically examines the gender-specific pathways ranging from gonadotropins to adiponectin expression and signalling, as well as how dysregulation of these pathways in the context of obesity leads to cardiac damage. We propose that dysfunction of epicardial adipose tissue acts as a key hub, with local inflammation and alterations in adipokine signalling exacerbating coronary atherosclerosis, myocardial fibrosis and arrhythmias. Furthermore, we have examined the clinical conundrum known as the adiponectin paradox in advanced cardiometabolic diseases. In summary, a deeper understanding of the gender dimorphism of adiponectin is crucial for recognising gender-specific susceptibilities and may provide a strategic basis for future approaches to addressing obesity-mediated cardiovascular complications.