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Background: Excess adipose tissue has been implicated in the pathogenesis of insulin resistance and atherosclerosis and is a key risk factor for blood pressure (BP) elevation. However, circulating levels of adiponectin, a protein produced by adipose tissue and widely implicated in the pathogenesis of insulin resistance and atherosclerosis, are inversely proportional to adiposity. The relationship between adiponectin and incident hypertension has not been determined in the general US population., Methods: Normotensive participants (n = 1233) enrolled in the Dallas Heart Study, a multiethnic, probability-based population sample of Dallas County adults were followed for median of 7 years. Retroperitoneal, intraperitoneal, visceral, and subcutaneous adipose tissue were measured at baseline by magnetic resonance imaging. Liver fat content was measured by 1 H-magnetic resonance spectroscopy. Relative risk regression was used to determine the association of adiponectin with incident hypertension after adjustment for age, race, sex, BMI, smoking, diabetes, baseline systolic BP, total cholesterol, and regional fat depot., Results: Of the 1233 study participants (median age 40 years, 40% black, and 56% women), 391 (32%) had developed hypertension over a median follow-up of 7 years. Adiponectin levels were associated with reduced risk of incident hypertension (RR 0.81, 95% CI [0.68-0.96]) in the fully adjusted model, which included liver fat. Similar results were observed after adjustment for subcutaneous or visceral fat depots when tested individually or simultaneously in the model., Conclusion: Our study suggested a protective role of adiponectin against incident hypertension independent of body fat distribution., (Copyright © 2016 John Wiley & Sons, Ltd.)

Adiponectin is a key component in multiple metabolic pathways. Studies evaluating associations of adiponectin with clinical outcomes in older adults have reported conflicting results. We investigated the association of adiponectin with mortality and cardiovascular disease (CVD) morbidity in a young, multiethnic adult population. We analyzed data from participants in the Dallas Heart Study without baseline CVD who underwent assessment of total adiponectin from 2000 to 2002. The primary outcome of all-cause mortality was assessed over median 10.4 years of follow-up using multivariable-adjusted Cox proportional hazards models. Secondary outcomes included CVD mortality, major adverse cardiovascular and cerebrovascular events (MACCE), and heart failure (HF). The study cohort included 3,263 participants, mean age 43.4 years, 44% women, and 50% black. There were 184 deaths (63 CVD), 207 MACCE, and 46 HF events. In multivariable models adjusted for age, gender, race, hypertension, diabetes, smoking, high-density lipoprotein cholesterol-C, hyperlipidemia, high-sensitivity C-reactive protein level, estimated glomerular filtration rate, and body mass index, increasing adiponectin quartiles were positively associated with all-cause mortality Q4 versus Q1 (hazard ratio [HR] = 2.27; 95% confidence interval [CI] 1.47, 3.50); CVD mortality Q4 versus Q1 (HR = 2.43; 95% CI 1.15, 5.15); MACCE Q4 versus Q1 (HR = 1.71; 95% CI 1.13, 2.60); and HF Q4 versus Q1 (HR = 2.95; 95% CI 1.14, 7.67). Findings were similar with adiponectin as a continuous variable and consistent across subgroups defined by age, gender, race, obesity, diabetes, metabolic syndrome, or elevated high-sensitivity C-reactive protein. In conclusion, higher adiponectin was associated with increased mortality and CVD morbidity in a young, multiethnic population. These findings may have implications for strategies aimed at lowering adiponectin to prevent adverse outcomes., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Context: Previous small case-control studies have suggested an inverse relationship between adiponectin and hepatic steatosis, but whether this finding is independent of insulin sensitivity and other intraabdominal fat depots is unclear. OBJECTIVES AND MAIN OUTCOME MEASURES: The objective of this study was to establish whether an independent relationship exists between serum adiponectin concentrations and liver fat., Design, Setting, and Patients: Adiponectin levels were compared with hepatic triglyceride content (HTGC) as assessed by proton magnetic resonance spectroscopy in 2215 participants from the Dallas Heart Study. Multivariate modeling was performed to control for the effects of intraabdominal fat, insulin sensitivity, and other baseline factors., Results: In unadjusted analysis, adiponectin levels displayed inverse correlations with the amount of intraabdominal fat and HTGC. After multivariate adjustment, including individual intraabdominal fat depots and homeostasis model assessment of insulin resistance, HTGC remained significantly associated with adiponectin levels (β = -1.46, P < 0.0001 for women; β = -1.81, P < 0.0001 for men). Race- and gender-specific models demonstrated that this association was consistent across groups, except for Hispanic men. The adjusted odds ratio for hepatic steatosis (HTGC > 5.5%) per 1-sd increase in adiponectin concentrations was 0.64 (95% confidence interval = 0.52-0.78) for women and 0.61 (95% confidence interval = 0.51-0.74) for men., Conclusion: Data from a large, multiethnic population-based cohort show adiponectin levels are inversely associated with hepatic steatosis even after controlling for measures of insulin sensitivity, extrahepatic abdominal adiposity, and ethnicity. The mechanistic underpinnings of this association warrant further exploration.