Adiponectin Isoforms in Elderly Patients with or without Coronary Artery Disease

OBJECTIVES To study the distribution of adiponectin isoforms in a group of very old patients. DESIGN Cross-sectional. SETTING Geriatric ambulatory clinic of the Department of Medicine at Policlinico "Tor Vergata." PARTICIPANTS One hundred eight elderly adults (mean age 85.0 +/- 3.2) with or without a history of a previous myocardial infarction as proof of established coronary artery disease (CAD) at least 3 months before entry into the study. Accordingly, subjects were divided into CAD positive (CAD+, n=50) and CAD negative (CAD-, n=58). MEASUREMENT Assessment of adiponectin isoforms along with metabolic, lipid, and inflammatory profiles. RESULTS CAD+ subjects had significantly higher levels of total adiponectin (Tot-Ad) and low-molecular-weight adiponectin (LMW-Ad) than CAD- subjects (P=.008 for both). LMW-Ad and high-sensitivity C-reactive protein were positively correlated, even after adjustment for waist circumference, sex, glomerular filtration rate, and presence of diabetes mellitus (correlation coefficient (r)=0.25, P=.05). This association was not confirmed when CAD+ subjects were analyzed alone. A positive association was found in CAD+ subjects between brain natriuretic peptide (BNP), high-molecular-weight adiponectin (HMW-Ad), and Tot-Ad (r=0.798 and r=0.795, P <.001 for all) but not LMW-Ad. CONCLUSION Distribution of adiponectin isoforms differed in populations of elderly subjects according to the presence of coronary atherosclerosis. The data support the hypothesis for a protective role of LMW-Ad during aging, although additional studies are needed to definitively clarify whether LMW-Ad plays a protective role in older people with a history of CAD.