Low Adiponectin Levels are Associated with Atherogenic Dyslipidemia and Lipid-Rich Plaque

Objective: To determine whether an association exists between adiponectin and plaque composition in human coronary arteries. Research Design and Methods: Adiponectin is an adipocyte-derived protein with antiatherogenic and insulin sensitizing properties. To date, the relationship between adiponectin and plaque composition is unknown. Fasting blood samples were collected from 185 patients undergoing coronary angiography and IVUS-. Plaque composition was categorized as fibrous, fibrofatty, necrotic core, or dense calcium and further classified as IVUS-derived (ID)-adaptive or pathological intimal thickening, fibroatheroma, fibrocalcific, or thin-cap fibroatheroma. Results: Adiponectin correlated with normalized plaque volume (r = -0.16, P = 0.025) and atheroma lipid content as measured by normalized fibrofatty volume (r = -0.19, P = 0.009). Low adiponectin levels were associated with ID-pathological intimal thickening (r = -0.18, P = 0.01). With increasing quartiles of adiponectin, normalized volume of fibrofatty plaque decreased (P=0.03) which was driven by reductions in the non-diabetic cohort (Q1: 44.2 mm; Q2: 28.2 mm; Q3: 24.7 mm; Q4: 23.4 mm, P = 0.01). No similar association was present in diabetic patients. Low adiponectin levels were also associated with ID-pathological intimal thickening in non-diabetic (r = -0.20, P = 0.03) but not diabetic patients. Conclusions: Low adiponectin levels are associated with atherogenic lipoproteins (elevated triglycerides, small dense LDL cholesterol, low HDL cholesterol), increased plaque volume, lipid-rich plaque, and ID-pathological intimal thickening in the total cohort which was driven by the non-diabetic population, suggesting an anti-atherogenic role in the early stages of lesion development.