Adiponectin, an adipocyte protein important in insulin sensitization and cardioprotection, has a strong genetic component. We hypothesized that variants in the adiponectin gene (adipocyte collagen-domain containing [ACDC]) contribute to adiponectin levels in a biracial adolescent cohort. We genotyped 11 ACDC single nucleotide polymorphisms (SNPs) in 631 non-Hispanic white and 553 AfricanAmerican unrelated adolescents in grades 5-12 randomly selected from the Princeton School District Study. ACDC SNPs ؊11,391 (A allele), ؊10,068 (G allele), and ؉276 (T allele) were associated with higher adiponectin, adjusting for sex, puberty stage, BMI Z score, and waist Z score. Contiguous two-SNP haplotypes of promoter variants ؊11,391/؊10,068 were significantly associated with adiponectin levels in whites and African Americans (P < 0.0001 and 0.03, respectively). Extended haplotypes from the promoter through the second intron (؊11,391 to ؉349) strongly associated with adiponectin in whites (P ؍ 6 ؋ 10 ؊11 ) and African Americans (P ؍ 0.004), but haplotypes of first intron SNPs ؊4,521 to ؊657 did not (P > 0.2). Noncontiguous haplotypes or interactions between two-SNP (؊11,391/؊10,068) and three-SNP (؉45, ؉276, and ؉349) haplotypes predicted adiponectin better than either region alone. Variants of ACDC are associated with adiponectin levels in whites and African Americans. Interactions between noncontiguous ACDC haplotypes strongly influence adiponectin levels, suggesting nonadditive and potentially cis relationships between these regions. Diabetes 55: [523][524][525][526][527][528][529] 2006 A diponectin is an abundant adipocyte-derived protein that has important roles in insulin sensitization, cardioprotection, and anti-inflammatory processes. Low adiponectin levels have been associated with the development of several cardiovascular end points, including myocardial infarction and hypertension (1,2), and may also have direct cardioprotective effects on vascular tissue (3-5). In addition, low adiponectin levels are associated with poor plasma lipid profiles in adults and children (6 -8) and precede insulin resistance and type 2 diabetes (9 -11).Adiponectin levels have a strong genetic component, with heritability estimated between 30 and 50% (12,13). The adiponectin protein is coded by the gene named adipocyte collagen-domain containing (ACDC). Linkage studies of adiponectin level have reported linkage peaks at the ACDC locus at chromosome 3q27 (14,15), which are reduced by the inclusion of ACDC SNPs in the linkage model (15). SNPs and haplotypes in ACDC are associated with adiponectin level (16,17), and some ACDC SNPs affect adiponectin expression or secretion (18,19). However, conflicting association results in various populations suggest a complex relationship between ACDC variation and phenotypic adiponectin levels.Adiponectin levels are typically lower in African Americans than whites (20,21). Few studies have explored the genetic basis for adiponectin levels in African Americans. One genome scan in African America...