title: Adiponectin multimeric forms but not total adiponectin levels are associated with myocardial infarction in non-diabetic men.
abstract: OBJECTIVE
  Multimer complex formation of adiponectin is recognized as an important mechanism modulating the biological functions of this adipokine, but the role of adiponectin isoforms in myocardial infarction (MI) is still unclear.
  
  
  METHODS
  We quantified total adiponectin (TOTAL), high, middle, and low molecular weight adiponectin multimers (HMW, MMW, LMW) in a study of non-diabetic obese (BMI ≥ 30 kg/m(2)) and normal-weight (BMI ≤ 25 kg/m(2)) male subjects with MI and healthy controls (n=180). Subsequently, we designed a prospective nested-case-control study to investigate the association of the adiponectin multimers with fatal and non-fatal MI in n=1236 initially healthy non-diabetic men.
  
  
  RESULTS
  Obesity was significantly related to lower levels of TOTAL, HMW, MMW, and LMW in subjects with and without MI (p < 0.01, each). In contrast, MI was strongly related to MMW/TOTAL (p < 0.0001), inversely to HMW/TOTAL (p < 0.0001), but not TOTAL or LMW levels. In particular, the median MMW/HMW ratios were markedly different in men with MI (1.71, interquartile range (1.08-2.40)) and without (0.72 (0.49-1.08), p < 0.0001). In the prospective study, 56 incident fatal and non-fatal MI events occured. The MMW/HMW ratio was associated with fatal and non-fatal MI up to 5 years before the event. The β-estimates for the relationship between MMW/HMW and incident MI decreased with increasing time to the event.
  
  
  CONCLUSIONS
  Whereas total adiponectin and all isoforms are related to obesity, total adiponectin and LMW levels are not associated with MI in non-diabetic men. In contrast, the MMW/HMW-ratio correlated with incident MI up to 5 years before the event. These data imply that measurement of adiponectin multimers adds significant value in assessing cardiovascular risk compared to total adiponectin alone.
authors.affiliation: Clinic for Internal Medicine II, University of Regensburg, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Baessler
authors.forename: Susanne
authors.initials: S
authors.lastname: Schlossbauer
authors.forename: Klaus
authors.initials: K
authors.lastname: Stark
authors.forename: Christina
authors.initials: C
authors.lastname: Strack
authors.forename: Günter
authors.initials: G
authors.lastname: Riegger
authors.forename: Heribert
authors.initials: H
authors.lastname: Schunkert
authors.forename: Christian
authors.initials: C
authors.lastname: Hengstenberg
authors.forename: Marcus
authors.initials: M
authors.lastname: Fischer
mesh_terms: D052242:Adiponectin / Q000097:blood / Q000737:chemistry*; D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000150:complications; D016022:Case-Control Studies; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis; D009765:Obesity / Q000097:blood; D011446:Prospective Studies; D020033:Protein Isoforms; D012044:Regression Analysis; D012307:Risk Factors
chemical_list: D052242:Adiponectin; D015415:Biomarkers; D020033:Protein Isoforms