title: High serum adiponectin concentration and low body mass index are significantly associated with increased all-cause and cardiovascular mortality in an elderly cohort, "adiponectin paradox": the Korean Longitudinal Study on Health and Aging (KLoSHA).
abstract: BACKGROUND
  The relationship between adiponectin concentration and mortality is unclear. We examined whether serum adiponectin concentration is associated with all-cause and cardiovascular mortality in elderly Asians.
  
  
  METHODS
  We analyzed the data for community-dwelling adults ≥65 years of age (439 men and 561 women) who were enrolled in the Korean Longitudinal Study on Health and Aging (KLoSHA) cohort in prospective manner. The baseline serum total and high molecular weight adiponectin were measured using an enzyme-linked immunosorbent assay. Using Cox regression, we determined the associations between serum adiponectin concentration and all-cause and cardiovascular mortality after adjusting for well-known cardiovascular risk factors.
  
  
  RESULTS
  Over a mean follow-up time of 6.2 years, 222 individuals died, and 52 deaths (23.4%) were by cardiovascular disease. After adjusting confounding factors, elevated baseline serum adiponectin concentration was independently associated with all-cause mortality (adjusted hazard ratio [HR] 1.38; 95% confidence interval [CI] 1.17-1.64) and cardiovascular mortality (HR 1.50; 1.06-2.14). We evaluated the effect modification by baseline body mass index (BMI). High serum adiponectin and low BMI were synergistically associated with increased all-cause mortality (HR 6.25; 3.08-12.71) and cardiovascular mortality (HR 13.94; 1.82-106.58).
  
  
  CONCLUSIONS
  Higher serum adiponectin concentration was associated with increased all-cause and cardiovascular mortality in community-dwelling elderly Asian population. Our data supported the recent theory so called "adiponectin paradox". This relationship was strengthened when combined with low BMI. We suggest that measurement of adiponectin concentration and BMI together could be an additional predictive marker of survival among elderly adults.
authors: Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors: Sung Hee
authors: SH
authors: Choi
authors: Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors: Eu Jeong
authors: EJ
authors: Ku
authors: Department of Internal Medicine, Konkuk University, Chungju, Republic of Korea.
authors: Eun Shil
authors: ES
authors: Hong
authors: Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors: Soo
authors: S
authors: Lim
authors: Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors: Ki Woong
authors: KW
authors: Kim
authors: Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors: Jae Hoon
authors: JH
authors: Moon
authors: Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors: Kyoung Min
authors: KM
authors: Kim
authors: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Young Joo
authors: YJ
authors: Park
authors: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Kyong Soo
authors: KS
authors: Park
authors: Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. Electronic address: janghak@snu.ac.kr.
authors: Hak Chul
authors: HC
authors: Jang
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000401:mortality*; D002423:Cause of Death; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies
chemical_list: D052242:Adiponectin
keywords: Adiponectin; All-cause mortality; Body mass index; Cardiovascular mortality; Cohort study; Elderly