Adiponectin

CPT: 83520

Updated on 04/16/2023

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Expected Turnaround Time

7 - 8 days

Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.

7 - 8 days

Related Information

Leptin, Serum or Plasma

Specimen Requirements

Specimen

Serum or plasma

Volume

0.3 mL

Minimum Volume

0.1 mL (Note:This volume does not allow for repeat testing.)

Container

Red-top tube, gel-barrier tube, or lavender-top (EDTA) tube

Collection

Separate serum or plasma from cells and transfer to an appropriate tube.

Storage Instructions

Refrigerate

Stability Requirements

Temperature	Period
Room temperature	14 days
Refrigerated	14 days
Frozen	14 days
Freeze/thaw cycles	Stable x3

Causes for Rejection

Nonserum or non-EDTA plasma received

Test Details

Use

This test is used to measure the level of adiponectin in serum or plasma.

Obesity is strongly associated with the pathogenesis of type 2 diabetes, hypertension, and cardiovascular disease.^1-4 Recent studies have suggested that adipose tissue may play an important role in the development of these conditions and their complications through the secretion of various bioactive molecules referred to as adipokines. Adipokines contribute to the pathophysiology of obesity-linked disorders through their abilities to modulate inflammatory and metabolic processes. Diminished levels of adiponectin have been associated with the increased prevalence of obesity-linked cardiovascular diseases, including ischemic heart disease and peripheral artery disease.³ Adiponectin is a plasma adipokine protein secreted specifically by adipose tissue.

Adiponectin automatically self-associates into trimers and larger multimers.¹ The primary protein sequence of adiponectin contains a collagen-like domain at the N terminus and a globular domain at the C terminus, similar to collagens VIII, X, and complement factor C1q.¹ Plasma levels of adiponectin are inversely correlated with body fat percentage in adults.

Levels of adiponectin are significantly reduced in obese subjects compared to nonobese subjects. Levels of adiponectin are reduced in diabetics compared to nondiabetics. Weight reduction significantly increases circulating levels.

Clinical and experimental studies suggest that low adiponectin levels contribute to the development of obesity-linked illness. Adiponectin has been associated with insulin resistance and linked with type II diabetes, as well as glucose and lipid metabolism. Adiponectin may have relevance for energy metabolism through the regulation of fatty acid oxidation. A number of studies have suggested that adiponectin plays a regulatory role in atherogenesis, endothelial function, and vascular remodeling.^1-10 Adiponectin is also involved in the inflammatory process and is of importance in the appearance of arteriosclerosis and coronaritis. It has been suggested that determination of the adiponectin level in plasma may serve to estimate the risk of coronary disease and may influence physiological processes such as angiogenesis. Further studies have shown that adiponectin acts directly on cardiac cells and facilitates cardiac remodeling in patients suffering from acute cardiac injury.^1-3,10 Higher prediagnosis adiponectin levels have also been associated with decreased risk of developing high-grade prostate cancer and a lower risk of prostate cancer-related death.¹¹

This test is used to measure the level of adiponectin in serum or plasma.

Limitations

This test was developed and its performance characteristics determined by Labcorp. It has not been cleared or approved by the Food and Drug Administration.

Results for this test are for research purposes only by the assay's manufacturer. The performance characteristics of this product have not been established. Results should not be used as a diagnostic procedure without confirmation of the diagnosis by another medically established diagnostic product or procedure.

This test was developed and its performance characteristics determined by Labcorp. It has not been cleared or approved by the Food and Drug Administration.

Methodology

Enzyme-linked immunosorbent assay (ELISA)

Reference Interval

See table.

Age (y)	Range (mL)
0 to 7	2.3−26.5
8 to 9	4.0−14.9
10 to 11	3.4−13.8
12 to 13	4.5−13.2
14 to 15	3.7−13.7
16 to 19	2.7−13.3
20 to 29	2.5−12.3
30 to 39	2.0−19.3
40 to 49	2.4−17.9
50 to 59	2.2−19.9
60 to 100	3.0−21.1

Additional Information

Adiponectin is the most abundant peptide hormone secreted by adipocytes.^1-3 Other cell types such as skeletal and cardiac myocytes and endothelial cells can produce lesser amounts of this protein. Adiponectin has a short half-life of 45-75 minutes despite its minimal degradation during circulation. Its clearance is predominantly by the liver but can also bind pancreatic beta cells and certain heart and kidney cell types.¹ Adiponectin participates in glucose regulation but also exerts anti-inflammatory, anti-atherogenic and cardioprotective effects as well as effects on lipid metabolism and fatty acid oxidation.^1,4 Adiponectin directly acts on the liver, skeletal muscle, and vasculature through insulin sensitization and anti-inflammatory/anti-atherogenic effects.¹ Adiponectin increases insulin secretion from the pancreas and mediates insulin sensitivity in skeletal muscle.^1,3,5 Adiponectin enhances basal glucose and insulin-stimulated glucose uptake in adipose tissues.^1,3,4 Adiponectin increases insulin sensitivity and down-regulates gluconeogenesis in the liver while activating fatty acid oxidation.^1,3 Studies have shown that adiponectin decreases inflammation in macrophages, endothelial tissue, muscle, and epithelial cells.³ There is evidence that adiponectin prevents the production of reactive oxidative species and promotes down-regulation of inflammation.³ Moreover, it has been shown to inhibit CRP secretion and suppression of pathways involving NF-kB signaling and TNF-Alpha.³

Obese patients tend to have decreased serum levels of adiponectin. Various cross-sectional studies have established an inverse relationship between adiponectin serum levels and BMI and fat mass.^6-8 Adiponectin levels are increased in extremely lean patients suffering from conditions such as anorexia nervosa.⁷ Weight loss through means such as diet and exercise and bariatric surgery have resulted in increased plasma levels of adiponectin in patients.⁷ Diminished serum adiponectin levels is a feature in pathologies such as gestational diabetes.^7,9 Strong genetic associations between adiponectin levels and insulin resistance have also been established⁵ and low levels of it predict future onset of insulin resistance.^7,10 Adiponectin levels demonstrate an inverse correlation with adiposity and proinflammatory cytokines in patients suffering from metabolic syndrome.^11-14 Low levels of adiponectin predict a higher incidence of adverse cardiovascular events such as myocardial infarctions and atherosclerosis.^14,15

Recently, adiponectin has shown to exhibit activity in functions of cell proliferation, where it has been shown to counter cell growth and induce apoptosis.¹⁴ It is also noteworthy, however, that several recent studies have also demonstrated adiponectin to have anti apoptotic and proliferative roles.¹⁴ Accumulating evidence suggest that adiponectin is implicated in the pathogenesis of several malignancies.^13,16,17 Several observational studies showed that low adiponectin levels are associated with higher risk for breast, cervical, endometrial, ovarian and prostate cancer.^13,16,17 A relationship between adiponectin and the aggressiveness of some of these tumors has also been reported.^13,16-18

Footnotes

1. Achari AE, Jain SK. Adiponectin, a Therapeutic Target for Obesity, Diabetes, and Endothelial Dysfunction. Int J Mol Sci. 2017 Jun 21;18(6):1321.28635626

2. Scherer PE. Adiponectin: basic and clinical aspects. Preface. Best Pract Res Clin Endocrinol Metab. 2014 Jan;28(1)1-2.24417940

3. Turer AT, Scherer PE. Adiponectin: mechanistic insights and clinical implications. Diabetologia. 2012 Sep;55(9):2319-2326.22688349

4. Nguyen TMD. Adiponectin: Role in Physiology and Pathophysiology. Int J Prev Med. 2020 Sep 3;11:136.33088464

5. Liu Y, Sweeney G. Adiponectin action in skeletal muscle. Best Pract Res Clin Endocrinol Metab. 2014 Jan;28(1):33-41.24417944

6. Nielsen MB, Çolak Y, Benn M, Nordestgaard BG. Low Plasma Adiponectin in Risk of Type 2 Diabetes: Observational Analysis and One- and Two-Sample Mendelian Randomization Analyses in 756,219 Individuals. Diabetes. 2021 Nov;70(11):2694-2705.34426507

7. Trujillo ME, Scherer PE. Adiponectin--journey from an adipocyte secretory protein to biomarker of the metabolic syndrome. J Intern Med. 2005 Feb;257(2):167-175.15656875

8. Nielsen MB, Çolak Y, Benn M, Nordestgaard BG. Causal Relationship between Plasma Adiponectin and Body Mass Index: One- and Two-Sample Bidirectional Mendelian Randomization Analyses in 460 397 Individuals. Clin Chem. 2020 Dec 1;66(12):1548-1557.33106853

9. Bao W, Baecker A, Song Y, Kiely M, Liu S, Zhang C. Adipokine levels during the first or early second trimester of pregnancy and subsequent risk of gestational diabetes mellitus: A systematic review. Metabolism. 2015 Jun;64(6):756-764.25749468

10. Mather KJ, Goldberg RB. Clinical use of adiponectin as a marker of metabolic dysregulation. Best Pract Res Clin Endocrinol Metab. 2014 Jan;28(1):107-117.24417950

11. Fisman EZ, Tenenbaum A. Adiponectin: a manifold therapeutic target for metabolic syndrome, diabetes, and coronary disease? Cardiovasc Diabetol. 2014 Jun 23;13:103.24957699

12. Fu Y. Adiponectin signaling and metabolic syndrome. Prog Mol Biol Transl Sci. 2014;121:293-319.24373241

13. Scheid MP, Sweeney G. The role of adiponectin signaling in metabolic syndrome and cancer. Rev Endocr Metab Disord. 2014 Jun;15(2):157-167.24019064

14. Nigro E, Scudiero O, Monaco ML, et al. New insight into adiponectin role in obesity and obesity-related diseases. Biomed Res Int. 2014;2014:658913.25110685

15. Hao G, Li W, Guo R, Yang JG et al. Serum total adiponectin level and the risk of cardiovascular disease in general population: a meta-analysis of 17 prospective studies. Atherosclerosis. 2013 May;228(1):29-35.23489345

16. Dalamaga M, Diakopoulos KN, Mantzoros CS. The role of adiponectin in cancer: a review of current evidence. Endocr Rev. 2012 Aug;33(4):547-594.22547160

17. Tsankof A, Tziomalos K. Adiponectin: A player in the pathogenesis of hormone-dependent cancers. Front Endocrinol (Lausanne). 2022 Oct 6;13:1018515.36277714

18. Li H, Stampfer MJ, Mucci L, et al. A 25-year prospective study of plasma adiponectin and leptin concentrations and prostate cancer risk and survival. Clin Chem. 2010 Jan;56(1):34-43.19910504

1. ~~Hopkins TA, Ouchi N, Shibata R, Walsh K. Adiponectin actions in the cardiovascular system. Cardiovasc Res. 2007 Apr 1; 74(1):11-18. 17140553~~

2. Walsh K. Adipokines, myokines and cardiovascular disease. Circ J. 2009 Jan; 73(1):13-18. 19043226

3. Shibata R, Ouchi N, Murohara T. Adiponectin and cardiovascular disease. Circ J. 2009 Apr; 73(4):608-614. 19261992

4. Bluher M, Brennan AM, Kelesidis T, et al. Total and high-molecular weight adiponectin in relation to metabolic variables at baseline and in response to an exercise treatment program: comparative evaluation of three assays. Diabetes Care, 2007 Feb; 30(2):280-285. 17259495

5. Li S, Shin HJ, Ding EL, van Dam RM. Adiponectin levels and risk of type 2 diabetes: A systematic review and meta-analysis. JAMA. 2009 Jul 8; 302(2):179-188. 19584347

6. Szmitko PE, Teoh H, Stewart DJ, Verma S. Adiponectin and cardiovascular disease: State of the art? Am J Physiol Heart Circ Physiol. 2007 Apr; 292(4):H1655-H1663. 17142348

7. Guerre-Millo M. Adiponectin: An update. Diabetes Metab. 2008 Feb; 34(1):12-18. 18069030

8. Antuna-Puente B, Feve B, Fellahi S, Bastard JP. Adipokines: The missing link between insulin-resistance and obesity. Diabetes Metab. 2008 Feb; 34(1):2-11. 18093861

9. Wang ZV, Scherer PE. Adiponectin, cardiovascular function, and hypertension. Hypertension. 2008 Jan; 51(1):8-14. 17998473

10. Goldstein BJ, Scalia RG, Ma XI. Protective vascular and myocardial effects of adiponectin. Nat Clin Pract Cardiovasc Med. 2009 Jan; 6(1):27-35. 19029992

11. Li H, Stampfer MJ, Mucci L, et al. A 25-year prospective study of plasma adiponectin and leptin concentrations and prostate cancer risk and survival. Clin Chem. 2010 Jan; 56(1):34-43. 19910504