Factors contributing to the risk of cardiovascular disease reflected by plasma adiponectin: Data from the coronary risk factors for atherosclerosis in women (CORA) study

Zyriax, Birgit-Christiane; Algenstaedt, Petra; Hess, Utz Florian; Schöffauer, Mark; Bamberger, Christoph; Boeing, Heiner; Windler, Eberhard

doi:10.1016/j.atherosclerosis.2007.12.033

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Volume 200, Issue 2 , Pages 403-409, October 2008

Factors contributing to the risk of cardiovascular disease reflected by plasma adiponectin:

Data from the coronary risk factors for atherosclerosis in women (CORA) study

Birgit-Christiane Zyriax
- Division of Endocrinology and Metabolism of Ageing, University Hospital Hamburg-Eppendorf, Hamburg, Germany
Petra Algenstaedt
- Department of Internal Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany
Utz Florian Hess
- Department of Internal Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany
Mark Schöffauer
- University of Heidelberg, School of Medicine, Germany
Christoph Bamberger
- Division of Endocrinology and Metabolism of Ageing, University Hospital Hamburg-Eppendorf, Hamburg, Germany
Heiner Boeing
- German Institute of Human Nutrition, Department of Epidemiology, Bergholz-Rehbrücke, Germany
Eberhard Windler
- Division of Endocrinology and Metabolism of Ageing, University Hospital Hamburg-Eppendorf, Hamburg, Germany
- Corresponding author at: Endokrinologie und Stoffwechsel des Alterns, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, D-20246 Hamburg, Germany. Tel.: +49 163 557 6082; fax: +49 40 571 491 01.

Received 16 October 2007; received in revised form 16 December 2007; accepted 21 December 2007. published online 13 February 2008.

Abstract

Objective

An inverse association of adiponectin with coronary heart disease (CHD) has been reported, but the results are inconsistent. We used data from the CORA study to investigate into plasma concentrations of adiponectin and factors that may mediate the link to incident CHD.

Design

The CORA study is a population-based case–control study on 200 women with incident CHD and 255 age-matched controls.

Results

Plasma concentrations of adiponectin were significantly lower in women with CHD (p<0.0001), and in women with BMI ≥25kg/m² (p<0.02), even more so with central obesity (WHR ≥0.85), prevalent diabetes or insulin resistance (HOMA-IR ≥3.8), or low HDL-cholesterol (<50mg/dl), and in smokers (each p<0.0001). Adiponectin also correlated with intake of fruit and vegetables, meat and sausage and alcohol as dietary markers of cardiovascular risk. Strikingly, the trend towards lower adiponectin concentrations with increasing BMI or waist circumference was less marked than the difference of adiponectin between CHD cases and controls. In a logistic regression model the odds ratio of adiponectin of 0.943 per 1μg/ml (CI 0.919–0.968, p<0.0001) for risk of CHD was progressively reduced by elevated WHR, obesity-related risk factors, smoking, and dietary parameters.

Conclusions

Plasma adiponectin indicates protection from CHD in women that is attenuated by combined effects of central obesity and dependent risk factors, parameters of nutrition and smoking. Thus, the impact of adiponectin goes beyond its relation to central adiposity, but may also reflect independent effects of lifestyle.

Abbreviations: BMI, body mass index, CHD, coronary heart disease, CI, confidence interval, HDL, high-density lipoprotein, HOMA-IR score, homeostasis model assessment of insulin resistance score, LDL, low-density lipoprotein, OD, odds ratio, TNF, tumor necrosis factor, WHR, waste-to-hip ratio