A lack of increase in high molecular weight-adiponectin in macroalbuminuric subjects with metabolic syndrome may exert renal and atherosclerotic risks.

We assessed serum levels of total- and HMW-adiponectin as well as carotid intima-media thickness (IMT) in relation to the levels of albuminuria in subjects with and without metabolic syndrome (MS). Consecutive 291 subjects were enrolled in this study. Waist circumference (WC) was measured and MS was diagnosed according to the Japanese criteria. Urinary albumin/creatinine ratio (ACR) was determined, and then divided into three stages; normo-, micro- and macroalbuminuria. Of all subjects, 95 were defined as having MS (MS+) and the other 196 were not (MS-). There was no significant difference in age between MS+ and MS- groups. The prevalence of micro- and macroalbuminuria was about twice as high in the MS+ than in the MS-. Although there was no difference in the WC among normo-, micro- and macroalbuminuric subjects in both MS+ and MS-, serum HMW-adiponectin levels and the HMW/total-adiponectin ratio in the macroalbuminuric MS- were significantly higher than that in the normo- and microalbuminuric MS-. However, these parameters did not change with an increase in urinary ACR among MS+. IMT was greatest in macroalbuminuric MS+ when compared with other groups. Multiple regression analysis revealed that HMW/total-adiponectin ratio is associated with urinary ACR independent of age, gender and presence of MS. We concluded that increased serum HMW-adiponectin by unknown mechanisms, at abstract least independent of WC, might help protect against renal and atherosclerosis risks in macroalbuminuric MS-.