33 Acta Cardiol 2015; 70(1): 33-40 doi: 10.2143/AC.70.1.3064591 Address for correspondence: Rosario Scaglione, MD, Assoc. prof. of Internal Medicine, Piazza delle Cliniche 2, 90127 Palermo, Italy. E-mail: rosarioscaglione@yahoo.it Received 12 August 2014; revision accepted for publication 16 October 2014. INTRODUCTION Adipose tissue has been identified as a metabolically active endocrine organ that affects several body func- tions, including cardiovascular function, through the release of important chemical mediators, termed adipo- cytokines 1,2 . Adiponectin (ADPN) is an adypocytokine produced predominantly by adipocytes and plays an important role Circulating adiponectin: a cardiometabolic marker associated with global cardiovascular risk Tiziana DI CHIARA, MD, PhD; Christiano ARGANO, MD, PhD; Alessandra SCAGLIONE, PhD; Salvatore CORRAO, MD; Antonio PINTO, Rosario SCAGLIONE, MD Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, ltaly. Objective This study was designed to evaluate the relationship among circulating adiponectin (ADPN), left ventricular mass (LVM) and cardio- metabolic comorbidities in subjects at higher global cardiovascular risk (score of “Cuore Project“). Methods 115 consecutive subjects were grouped according to normal or low ADPN levels. Left ventricular internal diameter (LVID/h), total LV mass (LVM), LVM index (LVMI), relative wall thickness (RWT), LV ejection fraction by echocardiography and diastolic parameters, by pulsed-wave Doppler were calculated. Results Low-ADPN subjects were characterized by a significantly higher prevalence of some cardiometabolic comorbidities (obesity, visceral obesity, diabetes and insulin resistance, LVH, metabolic syndrome (MetS), coronary artery syndrome (CAD). BMI (P < 0.0001), WHR (P < 0.03), triglycerides (P < 0.001), HOMA-IR (P < 0.001), LVM, LVMI, IVST and RWT (P < 0.0001) were significantly higher and HDL-C (P < 0.001) and LVEF were significantly lower in low-ADPN than in normal-ADPN subjects. LVMI correlated directly with BMI (P < 0.001), WHR (P < 0.001) MBP (P < 0.001), MetS (P < 0.001) and inversely with ADPN (P < 0.0001). Multiple regres- sion analysis indicated that ADPN was independently associated with LVMI. Conclusions ADPN might be considered a key component mediating the cross-talk between adipose tissue, cardiac cells and the vasculature. Accordingly, its routine measurement might become a new target in the management of global CV risk . Keywords Adiponectin – global cardiovascular risk – left ventricular hypertrophy. in metabolic and cardiovascular homeostasis. Circulating ADPN may act as a biologic marker and its decreased levels may act as a mediator for the pathophysiology in type-2 diabetes, metabolic syndrome, obesity, and ath- erosclerosis 2,3 . Low serum levels of ADPN have been asso- ciated with coronary artery disease (CAD), hypertension, left ventricular hypertrophy and a greater risk of myocar- dial infarction 2-5 . By contrast, high plasma levels of adi- ponectin are associated with a decreased risk of coronary heart disease, independently of other risk factors 6 . An inverse association between ADPN and left ven- tricular mass (LVM) has been reported 7,8 and our previ- ous data indicate that this relationship occurs indepen- dently of blood pressure 5 . ADPN receptors are expressed in cultured cardiac myocytes and heart tissue 9-11 , and experimental evidence implies that ADPN inhibits both hypertrophic signalling in the myocardium and pressure overload or angiotensin II-induced cardiac hypertrophy