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Diabetes Care 29:1357-1362, 2006
DOI: 10.2337/dc05-1801
© 2006 by the American Diabetes Association
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Cardiovascular and Metabolic Risk
Original Article

Measurement of the High–Molecular Weight Form of Adiponectin in Plasma Is Useful for the Prediction of Insulin Resistance and Metabolic Syndrome

Kazuo Hara, MD, PHD1,2, Momoko Horikoshi, MD, PHD1,2, Toshimasa Yamauchi, MD, PHD1,2, Hirokazu Yago3, Osamu Miyazaki3, Hiroyuki Ebinuma3, Yasushi Imai, MD, PHD4,5, Ryozo Nagai, MD, PHD4,5 and Takashi Kadowaki, MD, PHD1,2

1 Department of Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
2 Core Research for Evolutional Science and Technology, Japan Science and Technology, Tokyo, Japan
3 Diagnostics Research Laboratories, Daiichi Pure Chemicals, Ibaraki, Japan
4 Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
5 Department of Clinical Bioinformatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

Address correspondence and reprint requests to Dr. Takashi Kadowaki, Department of Metabolic Diseases, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. E-mail: kadowaki-3im{at}h.u-tokyo.ac.jp

OBJECTIVE—The high–molecular weight (HMW) form of adiponectin, an adipocyte-derived insulin-sensitizing hormone, has been reported to be the most active form of this hormone. We investigated whether measurement of plasma HMW adiponectin levels, using our newly developed enzyme-linked immunosorbent assay system for selective measurement of human HMW adiponectin level, may be useful for the prediction of insulin resistance and metabolic syndrome.

RESEARCH DESIGN AND METHODS—A total of 298 patients admitted for diabetes treatment or coronary angiography served as study subjects. Receiver operator characteristic (ROC) curves for the HMW ratio (HMWR; ratio of plasma level of HMW adiponectin to that of total adiponectin) and plasma total adiponectin levels were plotted to predict the presence of insulin resistance and metabolic syndrome.

RESULTS—The area under the ROC curve (AUC) of the HMWR values to predict the presence of insulin resistance was significantly larger than that of plasma total adiponectin level in total subjects (0.713 [95% CI 0.620–0.805] vs. 0.615 [0.522–0.708], P = 0.0160). The AUC for the HMWR values to predict the presence of metabolic syndrome was significantly larger than that for plasma total adiponectin levels in men (0.806 [0.747–0.865] vs. 0.730 [0.660–0.800], P = 0.0025) and in women (0.743 [0.659–0.828] vs. 0.637 [0.532–0.742], P = 0.0458).

CONCLUSIONS—The HMWR value has better predictive power for the prediction of insulin resistance and metabolic syndrome than plasma total adiponectin level.

Abbreviations: AUC, area under the curve • HMW, high molecular weight • HMWR, HMW ratio • HOMA-IR, homeostasis model assessment of insulin resistance • IDF, International Diabetes Federation • ROC, receiver operator characteristic


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