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To the Editor: Dr Pischon and colleagues¹ reported an inverse association between adiponectin levels and risk of myocardial infarction and death from coronary heart disease. Although the authors measured total levels of adiponectin, several studies have suggested that only the fraction bound to high-molecular-weight complexes is related to various indicators of insulin sensitivity.^2-4

Given the narrow range of the circulating levels of this abundant hormone, analysis of the fraction of adiponectin in high-molecular-weight complexes should be undertaken to establish the effect of population-based screening for total adiponectin levels.

Amnon Schlegel, MD, PhD
aschlege@caregroup.harvard.edu
Department of Medicine
Beth Israel Deaconess Medical Center
Boston, Mass

1. Pischon T, Girman CJ, Hotamisligil GS, Rifai N, Hu FB, Rimm EB. Plasma adiponectin levels and risk of myocardial infarction in men. JAMA. 2004;291:1730-1737. FREE FULL TEXT 2. Berg AH, Combs TP, Du X, Brownlee M, Scherer PE. The adipocyte secreted protein Acrp30 enhances hepatic insulin action. Nat Med. 2001;7:947-953. FULL TEXT | WEB OF SCIENCE | PUBMED 3. Pajvani UB, Hawkins M, Combs TP, et al. Complex distribution, not absolute amount of adiponectin, correlates with thiazolidinedione-mediated improvement in insulin sensitivity. J Biol Chem. 2004;279:12152-12162. FREE FULL TEXT 4. Pajvani UB, Du X, Combs TP, et al. Structure-function studies of the adipocyte-secreted hormone Acrp30/adiponectin: implications for metabolic regulation and bioactivity. J Biol Chem. 2003;278:9073-9085. FREE FULL TEXT

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;292:40.

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