Despite the established insulin-sensitizing and antiatherogenic properties of adiponectin, its predictive value in the development of future coronary heart disease (CHD) has not been definitively proven. Moreover, previous studies conducted among elderly individuals have reported a positive association between adiponectin levels and CHD risk. Accordingly, this case-control study by Kizer et al. provides further evidence that higher plasma adiponectin levels predict increased risk of first CHD in older men and women. Cases consisted of 282 men and 322 women matched to 366 men and 416 women free from the disease by age, sex, race, subclinical cardiovascular disease, and centre. After adjusting for waist-to-hip ratio, hypertension, smoking, alcohol consumption, LDL cholesterol, creatinine, and leptin, there was an increased risk of CHD associated with the highest quintile of adiponectin, an association that became stronger when focus was placed on the more severe outcome of nonfatal myocardial infarction and fatal CHD. Results of this study suggest that adiponectin levels are associated with both salutary and harmful properties in older men and women. Thus, additional research will be needed to better understand under what circumstances increased adiponectinemia is beneficial/harmful. The paper was accompanied by an editorial by Sattar and Nelson who discussed the paradoxical relationship between adiponectin levels and CHD risk. The authors underlined the important need for additional studies to better understand the exact role of adiponectin in vascular disease and the true nature of its association with CHD risk.
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