Pathophysiological significance of adiponectin.

Adipose tissue, which classically has been considered as an energy-storing organ, is now viewed as a massive source of bioactive substances such as leptin, tumor necrosis factor (TNF)-alpha, and adiponectin. Adiponectin was discovered to be the most abundant adipose-specific transcript. Its function had been unclear, but epidemiological and clinical studies have demonstrated that serum levels of adiponectin are inversely associated with body weight, especially abdominal visceral fat accumulation. In addition, adiponectin was inversely related to cardiovascular risk factors, such as insulin resistance, blood pressure, and low-density lipoprotein (LDL) cholesterol and triglyceride levels, and was positively related to high-density lipoprotein (HDL) cholesterol levels. Moreover, low adiponectin concentration is associated with a high incidence of cardiovascular disease (CVD), diabetes, some kinds of cancer, and other various diseases. These associations suggest the clinical significance of adiponectin, and a number of investigations are now being conducted to clarify the biological functions of adiponectin. Recent studies have revealed that adiponectin exhibits antiinflammatory, antiatherogenic, and antidiabetic properties. In addition, adiponectin has been thought to be a key molecule in "metabolic syndrome," which is an epidemiological target for preventing cardiovascular disease. Various functions of adiponectin may possibly serve to prevent and treat obesity-related diseases and CVD. Furthermore, enhancement of adiponectin secretion or action may become a promising therapeutic target.