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In Reply: Dr Schlegel points out that adiponectin fractions with a higher molecular weight may be more closely related to insulin sensitivity than the lower-molecular-weight hexamer (trimer-dimer) or the total amount of adiponectin.^1-3 Unfortunately, a standardized commercially available assay to measure adiponectin fractions in humans was unavailable at the time of our analysis. If anything, we suspect that our results underestimated the true relationship between high-molecular-weight adiponectin and risk of coronary heart disease. We have recently examined the stability and within-person variability of adiponectin to determine the feasibility of measuring this marker in large-scale epidemiologic studies.⁴ We are currently testing the feasibility to examine the relationship of various adiponectin fractions and coronary heart disease using similar methods. As we indicated, more studies are required to determine the role of adiponectin in human health and disease before offering population-based screening for adiponectin levels.

Tobias Pischon, MD, MPH
pischon@dife.de

Gokhan S. Hotamisligil, MD, PhD; Eric B. Rimm, ScD
Harvard School of Public Health
Boston, Mass

1. Scherer PE, Williams S, Fogliano M, Baldini G, Lodish HF. A novel serum protein similar to C1q, produced exclusively in adipocytes. J Biol Chem. 1995;270:26746-26749. FREE FULL TEXT 2. 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 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. Pischon T, Hotamisligil GS, Rimm EB. Adiponectin: stability in plasma over 36 hours and within-person variation over 1 year. Clin Chem. 2003;49:650-652. FREE FULL TEXT

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

JAMA. 2004;292:40.

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Amnon Schlegel
JAMA. 2004;292(1):40.
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