Abstract-Adiponectin is a novel, adipose-specific protein abundantly present in the circulation, and it has antiatherogenic properties. We analyzed the plasma adiponectin concentrations in age-and body mass index (BMI)-matched nondiabetic and type 2 diabetic subjects with and without coronary artery disease (CAD). Plasma levels of adiponectin in the diabetic subjects without CAD were lower than those in nondiabetic subjects (6.6Ϯ0.4 versus 7.9Ϯ0.5 g/mL in men, 7.6Ϯ0.7 versus 11.7Ϯ1.0 g/mL in women; PϽ0.001). The plasma adiponectin concentrations of diabetic patients with CAD were lower than those of diabetic patients without CAD (4.0Ϯ0.4 versus 6.6Ϯ0.4 g/mL, PϽ0.001 in men; 6.3Ϯ0.8 versus 7.6Ϯ0.7 g/mL in women). In contrast, plasma levels of leptin did not differ between diabetic patients with and without CAD. The presence of microangiopathy did not affect the plasma adiponectin levels in diabetic patients. Significant, univariate, inverse correlations were observed between adiponectin levels and fasting plasma insulin (rϭϪ0.18, PϽ0.01) and glucose (rϭϪ0.26, PϽ0.001) levels. In multivariate analysis, plasma insulin did not independently affect the plasma adiponectin levels. BMI, serum triglyceride concentration, and the presence of diabetes or CAD remained significantly related to plasma adiponectin concentrations. Weight reduction significantly elevated plasma adiponectin levels in the diabetic subjects as well as the nondiabetic subjects. These results suggest that the decreased plasma adiponectin concentrations in diabetes may be an indicator of macroangiopathy.

Background-Dysregulation of adipocyte-derived bioactive molecules plays an important role in the development of atherosclerosis. We previously reported that adiponectin, an adipocyte-specific plasma protein, accumulated in the injured artery from the plasma and suppressed endothelial inflammatory response and vascular smooth muscle cell proliferation, as well as macrophage-to-foam cell transformation in vitro. The current study investigated whether the increased plasma adiponectin could actually reduce atherosclerosis in vivo. Methods and Results-Apolipoprotein E-deficient mice were treated with recombinant adenovirus expressing human adiponectin (Ad-APN) or ␤-galactosidase (Ad-␤gal). The plasma adiponectin levels in Ad-APN-treated mice increased 48 times as much as those in Ad-␤gal treated mice. On the 14th day after injection, the lesion formation in aortic sinus was inhibited in Ad-APN-treated mice by 30% compared with Ad-␤gal-treated mice (PϽ0.05). In the lesions of Ad-APN-treated mice, the lipid droplets became smaller compared with Ad-␤gal-treated mice (PϽ0.01). Immunohistochemical analyses demonstrated that the adenovirus-mediated adiponectin migrate to foam cells in the fatty streak lesions. The real-time quantitative polymerase chain reaction revealed that Ad-APN treatment significantly suppressed the mRNA levels of vascular cell adhesion molecule-1 by 29% and class A scavenger receptor by 34%, and tended to reduce levels of tumor necrosis factor-␣ without affecting those of CD36 in the aortic tissue. Conclusions-These findings documented for the first time that elevated plasma adiponectin suppresses the development of atherosclerosis in vivo.

Objectives-A low level of high-density lipoprotein (HDL) in plasma has been recognized as an aspect of metabolic syndrome and as a crucial risk factor of cardiovascular events. However, the physiological regulation of plasma HDL levels has not been completely defined. Current studies aim to reveal the contribution of angiopoietin-like protein3 (angptl3), previously known as a plasma suppressor of lipoprotein lipase, to HDL metabolism. Methods and Results-Angptl3-deficient mice showed low plasma HDL cholesterol and HDL phospholipid (PL), and which were increased by ANGPTL3 supplementation via adenovirus. In vitro, ANGPTL3 inhibited the phospholipase activity of endothelial lipase (EL), which hydrolyzes HDL-PL and hence decreases plasma HDL levels, through a putative heparin-binding site in the N-terminal domain of ANGPTL3. Post-heparin plasma in Angptl3-knockout mice had higher phospholipase activity than did that in wild-type mice, suggesting that the activity of endogenous EL is elevated in Angptl3-deficient mice. Furthermore, we established an ELISA system for human ANGPTL3 and found that plasma ANGPTL3 levels significantly correlated with plasma HDL cholesterol and HDL-PL levels in human subjects. Key Words: angptl3 Ⅲ high density lipoprotein Ⅲ endothelial lipase Ⅲ phospholipase Ⅲ triglyceride P lasma concentrations of high-density lipoprotein (HDL) cholesterol are inversely correlated with the risk of atherosclerotic cardiovascular disease. 1 HDL cholesterol levels are low in patients with metabolic disorders, such as obesity, insulin resistance, and diabetes. 2,3 However, the genetic and metabolic factors that regulate HDL metabolism remain to be elucidated. Recently, endothelial lipase (EL) has been recognized as one factor that influences HDL metabolism. EL was originally discovered as a member of the family of triglyceride (TG)-lipases together with lipoprotein lipase (LPL) and hepatic lipase (HL). In contrast to LPL or HL, however, EL has relatively lower triglyceride lipase activity and substantially higher phospholipid lipase activity and can hydrolyze HDL phospholipids (PL). 4 Overexpression of EL in mice resulted in reduced plasma HDL levels and EL knockout mice showed significant increase in HDL levels, [5][6][7] indicating that EL regulates HDL metabolism. Conclusions-Angptl3In the colony of KK mice, characterized by obesity, diabetes mellitus, and hypertriglyceridemia, we recently identified a mutant subgroup of KK/Snk mice with low plasma TG levels despite maintaining the phenotype of obesity and diabetes. Genetic mapping and positional cloning identified the gene of angiopoietin-like protein 3 (Angptl3), which was mutated in the KK/Snk mice. The Angptl3 gene in KK/Snk mice contained a 4-bp nucleotide insertion in exon 6, which caused a premature stop codon attributable to a frameshift, leading to a lack of production of the protein. 8 Angptl3 mRNA is expressed exclusively in the livers of humans and mice. ANGPTL3 protein contains a signal sequence of 18 amino acids at the N terminus, followed b...

Objective-The contribution of visceral fat accumulation to the development of coronary heart disease was previously reported, but the relation between visceral fat accumulation and serum lipoprotein subclasses was unknown. Methods and Results-We examined the relation of lipoprotein subclasses with visceral fat accumulation in 62 male subjects (aged 22 to 67 years) with visceral fat syndrome or obesity. Cholesterol levels in very low-density, low-density, and high-density lipoprotein subclasses (VLDL, LDL, and HDL) were determined by computer-assisted high-performance liquid chromatography. Subcutaneous fat area and visceral fat area were measured by computed tomographic scanning. There was no significant correlation between the subcutaneous fat area and the cholesterol levels in all lipoprotein subclasses. In contrast, the visceral fat area was correlated positively (PϽ0.002) with VLDL and LDL subclasses, except for large LDL, but negatively (PϽ0.001) with those in large and medium HDL subclasses. The observed positive correlations of small and very small LDL subclasses remained significant (PϽ0.005) after adjustment for serum cholesterol, triglycerides, HDL cholesterol, and LDL cholesterol, respectively, but a significant negative correlation (PϽ0.