Circulating adiponectin and cardiovascular mortality in patients with type 2 diabetes mellitus: Evidence of sexual dimorphism

Claudia Menzaghi, Min Xu, Lucia Salvemini, Concetta De Bonis, Giuseppe Palladino, Tao Huang, Massimiliano Copetti, Yan Zheng, Yanping Li, Grazia Fini, Frank B. Hu, Simonetta Bacci, Lu Qi, Vincenzo Trischitta

Research output: Contribution to journalArticlepeer-review


Background: The pathogenesis of cardiovascular (CV) mortality, whose rate is increased in type 2 diabetes, is poorly understood.While high serum adiponectin is associated with increased CV mortality in the general population, no data are available in type 2 diabetes.We here investigated whether this counterintuitive association was observable also in diabetic patients and whether it was sex-specific.Methods: Three prospective cohorts were analyzed: 1) Gargano Heart Study (GHS; 359 patients, 58 events/1,934 person-years; py); 2) Health Professional Follow-up Study (HPFS; 833 men, 146 events/10,024 py); 3) Nurses' Health Study (NHS; 902 women, 144 events/15,074 py).Results: In GHS serum adiponectin predicted CV mortality in men (hazard ratio, HR, and 95% CI per standard deviation, SD, increment = 1.54, 1.19-2.01), but not women (HR = 0.98, 0.48-2.01).Circulating adiponectin predicted CV mortality in men from HPFS (HR = 1.44, 1.21-1.72), but not in women from NHS (HR = 1.08, 0.86-1.35), used as replication samples. In a pooled analysis, HRs were 1.47 (1.27-1.70) in 1,075 men and 1.07 (0.86-1.33) in 1,019 women (p for HRs heterogeneity across sexes = 0.018).Conclusions: This is the first report showing that high circulating adiponectin predicts increased CV mortality in men, but not in women with type 2 diabetes. Further studies are necessary to unravel the mechanisms through which adiponectin influences CV mortality in a sex-specific manner.

Original languageEnglish
Article number130
JournalCardiovascular Diabetology
Issue number1
Publication statusPublished - Aug 22 2014


  • Adipokines
  • Paradoxical effect
  • Prospective studies
  • Sex-linked genes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Endocrinology, Diabetes and Metabolism


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