The Role of Adiponectin in Cardiovascular Disease

Despite recent advances in both early diagnosis and in interventional techniques and pharmacological treatments targeting cardiovascular disease (CVD), cardiovascular mortality is the leading cause of death worldwide. The increasing incidence of CVD has spurred the interest of clinicians in elucidating all of the potential mechanisms that result in heart and vessel disease and in finding any potential therapy to improve CVD. Recent studies have suggested that adipose tissue is not only an energy depot but is also a highly dynamic endocrine organ that secretes a large number of bioactive molecules called adipokines [1]. The majority of adipokines released from adipose tissue, including adiponectin (Ad), tumor necrosis factor alpha (TNF-α), leptin, plasminogen activator inhibitor-1 (PAI-1) and resistin, are involved in many biological processes, such as metabolism and inflammation, and they also play a special role in the cardiovascular system [2, 3]. Both the heart and blood vessels are surrounded by adipose tissue. Epicardial adipose tissue is located along the large coronary arteries and on the surface of the ventricles and the apex of the heart, whereas perivascular adipose tissue surrounds the arteries. Therefore, adipokines secreted from epicardial and perivascular adipose tissue can directly modulate the function of the heart and the vasculature [4]. Adiponectin, with almost a 1000-fold concentration compared to that of other adipokines, is the most abundant peptide secreted by adipocytes. Adiponectin is also secreted by other cells and tissues, including cardiomyocytes [5]. Adiponectin exerts favorable effects on tissues, including maintaining energy homeostasis, anti-inflammatory reactions, anti-apoptotic effects, antihypertrophic responses, accelerated angiogenesis and inhibitory effects on interstitial fibrosis. Due to these positive actions, adiponectin has been extensively studied concerning cardiovascular protection in recent years, thus becoming the subject of intense preclinical research. This review focuses on a summary of current knowledge about the influence of adiponectin on cardiac and cardiovascular systems from in vitro and animal studies and the clinical significance of adiponectin in cardiovascular disease, as well as an understanding of the molecular and cellular mechanisms underlying the adiponectin system and a discussion of the method modulating adiponectin levels as a potential therapeutic strategy.

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