title: Low adiponectin levels at baseline and decreasing adiponectin levels over 10 years of follow-up predict risk of the metabolic syndrome.
abstract: OBJECTIVE
  Adiponectin is the most abundant adipokine and may play a key role in the interplay between obesity, inflammation, insulin resistance and the metabolic syndrome (MetS). Thus, this large population-based cohort investigated whether adiponectin at baseline and/or a decrease in adiponectin during follow-up is associated prospectively with the risk of incident MetS.
  
  
  METHODS
  Using a prospective study design, the development of MetS was examined in 1134 healthy participants from the community. Plasma adiponectin was measured at study entry and again after a median follow-up of 9.4 years (IQR: 9.2-9.7). During follow-up, 187 participants developed MetS, and 439 presented with at least two components of MetS.
  
  
  RESULTS
  During follow-up, adiponectin decreased in participants who developed MetS, whereas adiponectin was increased in those who did not develop MetS (P<0.001). Those with low adiponectin levels (quartile 1) at baseline had an increased risk of developing MetS (OR: 2.92, 2.08-6.97; P<0.001) compared with those with high levels (quartile 4). After adjusting for confounding variables, low adiponectin levels at baseline remained independently associated with MetS (OR: 2.24, 1.11-4.52; P=0.017). Similarly, participants with a decrease in adiponectin during follow-up also had an increased risk of MetS (OR: 2.96, 2.09-4.18; P<0.001). This association persisted after multivariable adjustments, including for baseline adiponectin (OR: 4.37, 2.77-6.97; P<0.001). Finally, adiponectin levels at follow-up were inversely associated with an increase in the number of components of MetS (P<0.001); geometric mean adiponectin levels were 9.5mg/L (95% CI: 9.0-10.0) for participants with no components vs 7.0mg/L (95% CI: 6.3-7.9) for those with four to five components.
  
  
  CONCLUSIONS
  Low plasma adiponectin levels at baseline and decreasing adiponectin levels during follow-up are both associated with an increased risk of MetS.
authors.affiliation: Copenhagen City heart study, Bispebjerg university hospital, Copenhagen, Denmark; Department of cardiology, Gentofte university hospital, 65, Niels Andersens Vej, 2900 Hellerup, Denmark. Electronic address: soerenli@hotmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Lindberg
authors.affiliation: Copenhagen City heart study, Bispebjerg university hospital, Copenhagen, Denmark; Department of cardiology, Gentofte university hospital, 65, Niels Andersens Vej, 2900 Hellerup, Denmark; Institute of clinical medicine, faculty of health sciences, university of Copenhagen, Copenhagen, Denmark.
authors.forename: J S
authors.initials: JS
authors.lastname: Jensen
authors.affiliation: The medical research laboratory, department of clinical medicine, Aarhus university, department of endocrinology and internal medicine, Aarhus university hospital, Aarhus, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Bjerre
authors.affiliation: The medical research laboratory, department of clinical medicine, Aarhus university, department of endocrinology and internal medicine, Aarhus university hospital, Aarhus, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Frystyk
authors.affiliation: The medical research laboratory, department of clinical medicine, Aarhus university, department of endocrinology and internal medicine, Aarhus university hospital, Aarhus, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Flyvbjerg
authors.affiliation: Institute of clinical medicine, faculty of health sciences, university of Copenhagen, Copenhagen, Denmark; Department of internal medicine, Hvidovre hospital, Glostrup, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Jeppesen
authors.affiliation: Copenhagen City heart study, Bispebjerg university hospital, Copenhagen, Denmark; Department of cardiology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: R
authors.initials: R
authors.lastname: Mogelvang
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis*; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D052242:Adiponectin; D015415:Biomarkers
keywords: Adiponectin; MetS; Metabolic syndrome