Objective Offspring of patients with type 2 diabetes (OPDs) exhibits endothelial dysfunction (ED) associated with a chronic inflammatory state. N-3 polyunsaturated fatty acids (n-3 PUFA) may have antioxidant and anti-inflammatory properties that are beneficial for cardiovascular and metabolic health. Therefore, in the present study, we tested the hypothesis that dietary supplementation with fish oil rich in n-3 PUFA may improve ED in otherwise healthy OPDs. Methods and design A double-blind, placebo-controlled trial was conducted with 50 OPDs. Participants were randomized to treatment with either placebo or n-3 PUFA (2 g/day) for 12 weeks. Before and after treatment we evaluated endothelial function (using flow-mediated dilation (FMD) of the brachial artery), circulating inflammatory markers (adiponectin, TNF-α, and high sensitivity-CRP), and insulin resistance (QUICKI). Results No significant changes were observed in study outcomes in subjects treated with placebo. By contrast, when compared with baseline values, subjects treated with n-3 PUFA had significant improvement in FMD (9.1 ± 5.8% vs. 11.7 ± 4.4%, p = 0.02) that was accompanied by decreased plasma triglycerides (117 ± 73 mg/dl vs. 86 ± 44 mg/dl, p = 0.001) and TNF-α levels (8.9 ± 2.3 pg/ml vs. 6.8 ± 2.7 pg/ml, p = 0.001), and a trend towards increased plasma adiponectin levels (7.8 ± 4.5 μg/ml vs. 9.5 ± 5.1 μg/ml, p = 0.09). When data were analyzed by multiple regression analysis, decreased TNF-α after treatment with n-3 PUFA predicted increased FMD. Conclusion Dietary supplementation with n-3 PUFA significantly improved endothelial function and reduced pro-inflammatory markers in OPDs. Thus, fish oil consumption may have beneficial cardiovascular and metabolic health effects in otherwise healthy subjects predisposed to diabetes and its vascular complications.

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OBJECTIVES:To study the distribution of adiponectin isoforms in a group of very old patients. DESIGN: Cross-sectional. SETTING: Geriatric ambulatory clinic of the Department of Medicine at Policlinico ''Tor Vergata.'' PARTICIPANTS: One hundred eight elderly adults (mean age 85.0 AE 3.2) with or without a history of a previous myocardial infarction as proof of established coronary artery disease (CAD) at least 3 months before entry into the study. Accordingly, subjects were divided into CAD positive (CAD1, n 5 50) and CAD negative (CAD À , n 5 58). MEASUREMENT: Assessment of adiponectin isoforms along with metabolic, lipid, and inflammatory profiles. RESULTS: CAD1 subjects had significantly higher levels of total adiponectin (Tot-Ad) and low-molecular-weight adiponectin (LMW-Ad) than CAD À subjects (P 5.008 for both). LMW-Ad and high-sensitivity C-reactive protein were positively correlated, even after adjustment for waist circumference, sex, glomerular filtration rate, and presence of diabetes mellitus (correlation coefficient (r) 5 0.25, P 5.05). This association was not confirmed when CAD1 subjects were analyzed alone. A positive association was found in CAD1 subjects between brain natriuretic peptide (BNP), highmolecular-weight adiponectin (HMW-Ad), and Tot-Ad (r 5 0.798 and r 5 0.795, Po.001 for all) but not LMW-Ad. CONCLUSION: Distribution of adiponectin isoforms differed in populations of elderly subjects according to the presence of coronary atherosclerosis. The data support the hypothesis for a protective role of LMW-Ad during aging, although additional studies are needed to definitively clarify whether LMW-Ad plays a protective role in older people with a history of CAD. J Am Geriatr Soc 58:702-706, 2010.Key words: adiponectin; elderly; coronary heart disease; inflammation A dipose tissue is an active metabolic tissue that secretes multiple hormones and growth factors, known as adipokines.1 Of them, adiponectin plays a major role because of its beneficial effects on glucose and lipid metabolism.2 Low levels of adiponectin are associated with metabolic disease states, in particular with components of metabolic syndrome, such as central obesity, high triglyceride levels, and low highdensity lipoprotein cholesterol (HDL-C) levels.3 Consistent with this, recent data from the Hoorn Study show that high adiponectin levels are associated with a lower risk of type 2 diabetes mellitus (DM2). 4 Moreover, many clinical studies have shown that hypoadiponectinemia is associated with endothelial dysfunction, greater carotid intima-media thickness, and coronary artery disease (CAD). 3,5,6 Consequently, low adiponectin levels can be included among the main factors underlying the link between DM2 and macrovascular disease, although several recent studies on prospective association between adiponectin and cardiovascular disease (CVD) showed controversial results.7-11 A report on the Hoorn Study found that high levels of adiponectin predict mortality in patients with prevalent CVD.12 Therefore, the cardiovascular action p...

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