Adiponectin, Its Roles in Diabetes and Cardiovascular Disease

The recent increase in obesity is a worldwide social problem. Because obesity leads to the enormous increases in the patients with diabetes mellitus (DM) and coronary artery disease (CAD), it has become a growing health threat. Many researchers have found that various bioactive molecules released from adipose tissues, which are conceptualized as adipocytokines/adipokines, are involved in the pathogenesis of obesity-associated diseases. Adiponectin is an adipocytokine that exerts insulin-sensitizing effects in the liver and skeletal muscle and suppresses atherosclerosis in vascular walls via various anti-inflammatory effects. Clinically, circulating adiponectin levels inversely correlate with body mass index (BMI), which may explain the molecular basis that underlies obesity-associated development of DM and CAD. Many clinical studies have demonstrated that low circulating adiponectin levels are associated with the incidence of DM and CAD.

Recently, we showed that reduced adiponectin levels were associated with multi-vessel coronary artery atherosclerosis as detected on computed tomography coronary angiography (CTCA), and adiponectin may be a useful biomarker to predict multivessel coronary atherosclerosis when detected using CTCA in combination with common risk factors including age, sex, DM, and hypertension. Moreover, in another study, we showed that reduced adiponectin levels were associated with elevated serum oxidized low-density lipoprotein levels in which dyslipidemic components of metabolic syndrome were strongly involved. Thus, adiponectin levels are associated directly and indirectly with the development of atherosclerosis.

Measuring adiponectin concentration should provide beneficial information for the selection of high-risk patients and contribute to the reduction of fatal CAD by applying aggressive preventive therapy.

Keywords: Adiponectin, Diabetes mellitus, Metabolic syndrome, Obesity, Oxidized LDL.