6.6 Waist Circumference Is A Better Predictor Of Subclinical Atherosclerosis Than Adiponectin Level

Objective Waist circumference is clinical marker of obesity and a well-established risk factor for cardiovascular disease. Adiponectin, an adipo-cyte-derived hormone and new biomarker of obesity, has recently been proposed to be the missing link between obesity and increased cardiovascular risk. We evaluated waist circumference and adiponectin level in a middle-aged population-based cohort to determine which marker of obesity was the best predictor of subclinical atherosclerosis. Methods and Results: Seven non-invasive measurements of atherosclerosis(-NIMA), as surrogate markers of subclinical atherosclerosis, were determined in 1517 participants of the Nijmegen Biomedical Study, aged 50–70 years who were drawn from the Dutch community. Both men and women with a high waist(M > 104 cm;F > 95 cm) showed deteriorated outcomes of NIMA as reflected by increased pulse wave velocity(PWV)(M:+12.6%;F:+13.1%) and thicker intima-media thickness (IMT)(M:+9.0%;F:+6.6%) and in women an increased plaque thickness(+22.1%). However, participants with a low adiponectin level(M < 2.2 mg/L;F< 3.5 mg/L) showed no changes in the outcomes of NIMA; in both sexes only after adjustment for age a decreased ankle-brachial index after exercise(M:-9%;F:-3.5%) and an increased IMT(M:3.7%;F:3.6%) and in women an increased PWV(+6.8%) was observed. Interaction between the effect of waist and adiponectin on NIMA was found only in women. Conclusions: Waist circumference was a better predictor of subclinical atherosclerosis than adiponectin level in our large population-based cohort. Measurement of waist circumference in clinical practice is a valuable tool in cardiovascular risk profiling, but our data does not support the measurement of adiponectin level.