Adiponectin, Its Roles in Diabetes and Cardiovascular Disease
Pp. 173-187 (15)
Morihiro Matsuda, Ritsu Tamura and Toshiharu Kawamoto
The recent increase in obesity is a worldwide social problem. Because
obesity leads to the enormous increases in the patients with diabetes mellitus (DM) and
coronary artery disease (CAD), it has become a growing health threat. Many
researchers have found that various bioactive molecules released from adipose tissues,
which are conceptualized as adipocytokines/adipokines, are involved in the
pathogenesis of obesity-associated diseases. Adiponectin is an adipocytokine that
exerts insulin-sensitizing effects in the liver and skeletal muscle and suppresses
atherosclerosis in vascular walls via various anti-inflammatory effects. Clinically,
circulating adiponectin levels inversely correlate with body mass index (BMI), which
may explain the molecular basis that underlies obesity-associated development of DM
and CAD. Many clinical studies have demonstrated that low circulating adiponectin
levels are associated with the incidence of DM and CAD.
Recently, we showed that reduced adiponectin levels were associated with multi-vessel
coronary artery atherosclerosis as detected on computed tomography coronary
angiography (CTCA), and adiponectin may be a useful biomarker to predict multivessel
coronary atherosclerosis when detected using CTCA in combination with
common risk factors including age, sex, DM, and hypertension. Moreover, in another
study, we showed that reduced adiponectin levels were associated with elevated serum
oxidized low-density lipoprotein levels in which dyslipidemic components of metabolic
syndrome were strongly involved. Thus, adiponectin levels are associated directly and indirectly with the development of atherosclerosis.
Measuring adiponectin concentration should provide beneficial information for the
selection of high-risk patients and contribute to the reduction of fatal CAD by applying
aggressive preventive therapy.
Adiponectin, Diabetes mellitus, Metabolic syndrome, Obesity,
Deptartment of Cardiology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, 3-1 Aoyama-cho, Kure 737-0023, Japan.