Relationship of adiponectin to body fat distribution, insulin sensitivity and plasma lipoproteins: evidence for independent roles of age and sex

Aims/hypothesis. Increased intra-abdominal fat is associated with insulin resistance and an atherogenic lipoprotein profile. Circulating concentrations of adiponectin, an adipocyte-derived protein, are decreased with insulin resistance. We investigated the relationships between adiponectin and leptin, body fat distribution, insulin sensitivity and lipoproteins. Methods. We measured plasma adiponectin, leptin and lipid concentrations, intra-abdominal and subcutaneous fat areas by CT scan, and insulin sensitivity index (S,) in 182 subjects (76 M/106F). Results. Adiponectin concentrations were higher in women than in men (7.4 +/- 2.9 vs 5.4 +/- 2.3 mug/ml, p<0.0001) as were leptin concentrations (19.1 +/- 13.7 vs 6.9 +/- 5.1 ng/ml, p<0.0001). Women were more insulin sensitive (S-I: 6.8 +/- 3.9 vs 5.9 +/- 4.4 x 10(-5) min(-1)/(pmol/l), p<0.01) and had more subcutaneous (240 133 vs 187 +/- 90 cm(2), p<0.01), but less intra-abdominal fat (82 57 vs 124 68 cm2, p<0.0001). By simple regression, adiponectin was positively correlated with age (r=0.227, p<0.01) and S-I(r=0.375, p<0.0001), and negatively correlated with BMI (r=-0.333, p<0.0001), subcutaneous (r=-0.168, p<0.05) and intra-abdominal fat (r=-0.35, p<0.0001). Adiponectin was negatively correlated with triglycerides (r=-0.281, p<0.001) and positively correlated with HDL cholesterol (r=0.605, p<0.0001) and Rf, a measure of LDL particle buoyancy. (r=0.474, p<0.0001). By multiple regression analysis, adiponectin was related to age (p<0.0001), sex (p<0.005) and intra-abdominal fat (p<0.01). S, was related to intra-abdominal fat (p<0.0001) and adiponectin (p<0.0005). Both intra-abdominal fat and adiponectin contributed independently to triglycerides, HDL cholesterol and RE Conclusion/interpretation. These data suggest that adiponectin concentrations are determined by intra-abdominal fat mass, with additional independent effects of age and sex. Adiponectin could link intra-abdominal fat with insulin resistance and an atherogenic lipoprotein profile.