title: Total adiponectin and risk of symptomatic lower extremity peripheral artery disease in men.
abstract: OBJECTIVE
  Lower concentrations of adiponectin have been linked to subsequent risk of coronary heart disease in healthy individuals. Whether similar relationships exist for the development of systemic atherosclerosis, such as peripheral artery disease (PAD), is uncertain. We investigated the association between total adiponectin and risk of lower extremity PAD.
  
  
  RESULTS
  We performed a prospective, nested case-control study among 18,225 male participants of the Health Professionals Follow-up Study who were free of diagnosed cardiovascular disease at the time of blood draw (1993-1995). During 14 years of follow-up, 143 men developed PAD. Using risk set sampling, controls were selected in a 3:1 ratio and matched on age, smoking status, fasting status, and date of blood draw (n=429). Median (interquartile range) adiponectin concentrations at baseline were lower among cases compared with controls (4.1 [3.2-5.5] versus 5.4 [3.8-7.5] µg/mL; P<0.001). A log-linear inverse association was evident over the full spectrum of adiponectin concentrations with PAD risk after controlling for baseline cardiovascular risk factors using restricted spline conditional logistic regression. Adiponectin was associated with a 42% lower risk of PAD per SD increase in natural log-transformed adiponectin (relative risk, 0.58; 95% confidence interval, 0.45-0.74) after adjustment for cardiovascular risk factors. The relative risk was attenuated (relative risk, 0.68; 95% confidence interval, 0.51-0.92) after further accounting for high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, C-reactive protein, and cystatin C. Additional adjustment for hemoglobin A(1c), triglycerides, and γ-glutamyltransferase had little impact on this association (relative risk, 0.68; 95% confidence interval, 0.50-0.92).
  
  
  CONCLUSIONS
  Total adiponectin is inversely associated with risk of symptomatic lower extremity PAD in men.
authors: Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA. hpmmj@channing.harvard.edu
authors: Michel M
authors: MM
authors: Joosten
authors: Kaumudi J
authors: KJ
authors: Joshipura
authors: Jennifer K
authors: JK
authors: Pai
authors: Monica L
authors: ML
authors: Bertoia
authors: Eric B
authors: EB
authors: Rimm
authors: Murray A
authors: MA
authors: Mittleman
authors: Kenneth J
authors: KJ
authors: Mukamal
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000368:Aged; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000097:blood / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D052242:Adiponectin; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human