title: Adiponectin, type 2 diabetes and cardiovascular risk.
abstract: BACKGROUND
  Adiponectin is viewed as an insulin-sensitizing hormone with anti-inflammatory effects. In accordance, plasma adiponectin is decreased in metabolic disorders including type 2 diabetes mellitus (T2DM). However, in spite of the apparently beneficially effects, recent data from large prospective studies have consistently linked high adiponectin levels with increased cardiovascular (CV) disease and mortality, thus questioning the positive view on adiponectin. Accordingly, we investigated the relationship between adiponectin, incident T2DM and subsequently CV events.
  
  
  METHODS
  We prospectively followed 5349 randomly selected men and women from the community, without T2DM or CV disease. Plasma adiponectin was measured at study entry. Median follow-up time was 8.5 years (IQR 8.0-9.1 years). During follow up, 136 participants developed T2DM. Following their diagnosis, 36 of the 136 participants experienced a CV event (myocardial infarction, ischaemic stroke, or CV death).
  
  
  RESULTS
  Participants with increasing adiponectin had reduced risk of developing T2DM (p < 0.001). After adjustment for confounding risk factors (including age, gender, body mass index, physical activity, alcohol consumption, blood glucose, HbA1c, blood pressure, lipids, high-sensitivity C-reactive protein, estimated glomerular filtration rate, and plasma N-terminal pro-brain natriuretic peptide, competing risk Cox-regression analysis identified adiponectin as an independent predictor of T2DM: hazard ratio (HR) for each doubling of adiponectin 0.55 (95% CI 0.41-0.74; p < 0.001). After development of T2DM, the risk of a CV event more than doubled. Increasing adiponectin (adjusted for the confounding risk factors mentioned) was associated with reduced risk of CV events: HR 0.34 (95% CI 0.16-0.72; p = 0.005) for each doubling in plasma adiponectin.
  
  
  CONCLUSIONS
  In conclusion, increasing plasma adiponectin is associated with decreased risk of T2DM and subsequently reduced risk of CV events.
authors.affiliation: Bispebjerg University Hospital, Copenhagen, Denmark Gentofte University Hospital, Copenhagen, Denmark soerenli@hotmail.com.
authors.forename: Søren
authors.initials: S
authors.lastname: Lindberg
authors.affiliation: Bispebjerg University Hospital, Copenhagen, Denmark Gentofte University Hospital, Copenhagen, Denmark University of Copenhagen, Copenhagen, Denmark.
authors.forename: Jan Skov
authors.initials: JS
authors.lastname: Jensen
authors.affiliation: Aarhus University, Aarhus, Denmark Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Mette
authors.initials: M
authors.lastname: Bjerre
authors.affiliation: Gentofte University Hospital, Copenhagen, Denmark.
authors.forename: Sune H
authors.initials: SH
authors.lastname: Pedersen
authors.affiliation: Aarhus University, Aarhus, Denmark Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Jan
authors.initials: J
authors.lastname: Frystyk
authors.affiliation: Aarhus University, Aarhus, Denmark Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Allan
authors.initials: A
authors.lastname: Flyvbjerg
authors.affiliation: Gentofte University Hospital, Copenhagen, Denmark.
authors.forename: Søren
authors.initials: S
authors.lastname: Galatius
authors.affiliation: University of Copenhagen, Copenhagen, Denmark Glostrup Hospital, Copenhagen, Denmark.
authors.forename: Jørgen
authors.initials: J
authors.lastname: Jeppesen
authors.affiliation: Bispebjerg University Hospital, Copenhagen, Denmark Gentofte University Hospital, Copenhagen, Denmark.
authors.forename: Rasmus
authors.initials: R
authors.lastname: Mogelvang
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000401:mortality / Q000517:prevention & control; D016009:Chi-Square Distribution; D003718:Denmark / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000175:diagnosis / Q000401:mortality / Q000517:prevention & control; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D015854:Up-Regulation; D055815:Young Adult
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers
keywords: Adiponectin; T2DM; cardiovascular disease; type 2 diabetes