Association of Serum Adiponectin Biomarker with Metabolic Syndrome Components in Koreans with Extremely High HDL Cholesterol Levels in General Health Checkup

Abstract

Adiponectin and high-density lipoprotein cholesterol (HDL-C) are negative predictors for cardio-metabolic disorders. This study explored adiponectin's role in predicting multiple metabolic syndrome components (multi-MetSC) in subjects with extremely high HDL-C levels overall and by sex. We enrolled adults with extremely high HDL-C levels (≥90 mg/dL) in general health checkups and compared adiponectin levels in subjects with and without multi-MetSC. Among 274 subjects (median 44 years, female 79.6%), 19 (6.9%) had a multi-MetSC. The adiponectin level was significantly lower in subjects with multi-MetSC than without (females: 9.2 [6.2-13.3] vs. 12.0 [9.7-15.9] µg/mL, p = 0.039; males: 6.9 ± 2.4 vs. 10.0 ± 5.2 µg/mL, p = 0.013). The optimal cutoff values to predict multi-MetSC were 9.7 µg/mL (sensitivity 64%, specificity 74%) in females and 9.6 µg/mL (sensitivity 100%, specificity 44%) in males. Compared with the high adiponectin group, the low group revealed higher fasting glucose in females and higher waist circumference, visceral fat area, and HDL-C levels in males. Multiple logistic regression analysis confirmed adiponectin as an independent predictor of multi-MetSC (OR 0.85, 95% CI 0.71-0.97). Adiponectin could be a potential biomarker for multi-MetSC in general health checkup subjects with extremely high HDL-C levels. There were sex differences in the metabolic risk factors between low and high adiponectin groups.

Keywords: adiponectin; biomarkers; metabolic syndrome.

Figure 1

Box-and-whisker dot plots. Four group comparisons of serum adiponectin levels according to the number of metabolic syndrome (MetS) components. Kruskal–Wallis test with Turkey’s post hoc test was used: (0 vs. 1) p = 0.99, (0 vs. 2) p = 0.04, (0 vs. 3) p = 0.11, (1 vs. 2) p = 0.075, (1 vs. 3) p = 0.15, and (2 vs. 3) p = 0.99.

Figure 2

Box-and-whisker dot plots. Two group comparisons of serum adiponectin levels with or without multiple metabolic syndrome components (≥2) in all subjects (a), females (b), and males (c). An independent two-sample test (t-test or Mann–Whitney test) was used after the normality test.

Figure 3

The receiver operating characteristic curves for serum adiponectin levels to predict multi-metabolic syndrome components ((a): All subjects, (b): Females, and (c): Males). The area under the curve (AUC) with a 95% confidence interval is shown in each group. The optimal cutoff value by the Youden index is presented with sensitivity (Sens), specificity (Spec), positive predictive value (PPV), and negative predictive value (NPV).