Adiponectin, a recently discovered adipocyte-derived peptide, is involved
in the regulation of insulin sensitivity and lipid oxidation and, purportedly,
in the development of atherosclerosis and coronary heart disease in humans.
To assess prospectively whether plasma adiponectin concentrations are
associated with risk of myocardial infarction (MI).
Design, Setting, and Participants
Nested case-control study among 18 225 male participants of the
Health Professionals Follow-up Study aged 40 to 75 years who were free of
diagnosed cardiovascular disease at the time of blood draw (1993-1995). During
6 years of follow-up through January 31, 2000, 266 men subsequently developed
nonfatal MI or fatal coronary heart disease. Using risk set sampling, controls
were selected in a 2:1 ratio matched for age, date of blood draw, and smoking
status (n = 532).
Main Outcome Measure
Incidence of nonfatal MI and fatal coronary heart disease by adiponectin
After adjustment for matched variables, participants in the highest
compared with the lowest quintile of adiponectin levels had a significantly
decreased risk of MI (relative risk [RR], 0.39; 95% confidence interval [CI],
0.23-0.64; P for trend <.001). Additional adjustment
for family history of MI, body mass index, alcohol consumption, physical activity,
and history of diabetes and hypertension did not substantively affect this
relationship (RR, 0.41; 95% CI, 0.24-0.70; P for
trend <.001). Further adjustment for hemoglobin A1c or C-reactive
protein levels also had little impact, but additional adjustment for low-
and high-density lipoprotein cholesterol levels modestly attenuated this association
(RR, 0.56; 95% CI, 0.32-0.99; P for trend = .02).
High plasma adiponectin concentrations are associated with lower risk
of MI in men. This relationship can be only partly explained by differences
in blood lipids and is independent of inflammation and glycemic status.