American Journal of Epidemiology Advance Access originally published online on November 13, 2006
American Journal of Epidemiology 2007 165(2):164-174; doi:10.1093/aje/kwk001
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ORIGINAL CONTRIBUTIONS |
Association of Adiponectin with Coronary Heart Disease and Mortality
The Rancho Bernardo Study
1 Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, La Jolla, CA
2 Department of Epidemiology and Public Health, Medical School, University College London, London, United Kingdom
Correspondence to Dr. Gail A. Laughlin, Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, 9500 Gilman Drive, Room 0631C, La Jolla, CA 92093 (e-mail: glaughlin{at}ucsd.edu).
Hypoadiponectinemia has been implicated in the development of obesity-related conditions, including dyslipidemia and coronary heart disease (CHD). In this study, the authors examined the association of adiponectin with CHD prevalence, incidence, and mortality among 1,513 community-dwelling men and women aged 50–91 years who were followed from 1984–1987 through 2004. In cross-sectional analyses, adiponectin concentrations were positively related to female sex, age, and high density lipoprotein cholesterol level and inversely related to waist girth, triglyceride level, and fasting plasma glucose level (all p's < 0.001). Adiponectin levels in the highest sex-specific quintile, as compared with the lowest, were associated with 44% decreased odds of prevalent CHD (p for trend = 0.03); adjustment for high density lipoprotein cholesterol and/or triglycerides eliminated this association. In 20-year prospective analyses, higher adiponectin concentrations predicted reduced risk of nonfatal myocardial infarction in men only; adiponectin was not associated with fatal incident CHD events or 20-year CHD mortality (n = 215 deaths) in either sex. Adiponectin levels in the highest sex-specific quintile, as compared with lower levels, were associated with almost 40% increased risks of cardiovascular disease death (n = 441) and death from all causes (n = 925), independent of age, sex, waist girth, lipid levels, and glucose level (both p's < 0.001). These results suggest that use of adiponectin for cardiovascular disease risk stratification is premature.
adiponectin; cardiovascular diseases; coronary disease; mortality
Abbreviations: CHD, coronary heart disease; HDL, high density lipoprotein
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