Reagent | Adiponectin
A Unique Marker of Metabolic Risk Assessment
The automated latex enhanced immunoturbidimetric method produces results in as little as ten minutes, facilitating faster patient diagnosis and treatment plan implementation compared to traditional ELISA based testing.
A correlation coefficient of r=0.989 was displayed when the new Randox methodology was compared against the old Randox methodology.
Extensive measuring range
The healthy range for adiponectin is 2 – 22μg/ml. The Randox adiponectin assay can comfortably detect levels outside of the healthy range, measuring between 0.32 – 23.8μg/ml.
Liquid ready-to-use assay
The Randox adiponectin assay is available in a liquid ready-to-use format for convenience and ease-of-use.
Dedicated 6-point calibrator and control
Dedicated adiponectin 6-point calibrator and control available offering a complete testing package.
Applications are available
Applications are available detailing instrument-specific settings for the convenient use of the Randox adiponectin assay on a variety of clinical chemistry analysers. Contact us to enquire about your specific analyser.
Adiponectin (ADPN) (adipocyte complement-related protein of 30kDa (Acrp30)) is an adipokine (protein hormone) produced and secreted by the adipose tissue, an endocrine organ 1. ADPN acts as a messenger in the communication of adipose tissue and metabolic organs. In doing so, ADPN suppresses the production of glucose in the liver through inhibiting the genes involved in glucose production and enhances fatty acid oxidation in skeletal muscle 2. Consequently, ADPN is a strong protector against several pathological events in various cells through inhibiting inflammation, suppressing cell death and enhancing cell survival 2.
ADPN has been identified as having pleiotropic functions widely associated with anti-atherogenic, anti-diabetic, cardioprotective and anti-inflammatory effects. ADPN levels inversely correlate with insulin levels, BMI, triglyceride levels, insulin resistance (IR), glucose, and most importantly, visceral fat accumulation 3. Moreover, physiological functions of adiponectin have also been observed in inflammation and cardiovascular disease (CVD), especially in atherosclerosis 2.
Fig. 1. Proposed salutary effects of adiponectin 1
ADPN has an inverse correlation with abdominal visceral fat (AVF). Low levels of ADPN increases the risk of metabolic abnormalities. Furthermore, excess adipose tissue, especially visceral adipose tissue (VAT) is an important risk factor for IR, correlating with an increased risk of CVD 4.
The most commonly utilised methods for the assessment of AVF are waist circumference and BMI. Waist circumference does not measure total AVF reliably as the visceral fat / subcutaneous fat ratios vary by gender and ethnicity 5 and BMI cannot distinguish between muscle and fat and so classes those with high muscle and low fat mass as being overweight. Moreover, BMI also cannot distinguish between visceral fat and fat that sits beneath the skin 6.
Adiponectin levels are inversely correlated with AVF, proving to be a reliable indicator of at-risk patients.
The traditional biomarkers utilised in the assessment of T2DM risk include: oral glucose tolerance test (OGTT), fasting plasma glucose (FPG) and HbA1c. However, each of these tests are inadequate and a superior biomarker for T2DM risk assessment is vital.
1. JAMA (2009): Adiponectin levels and risk of type 2 diabetes: A systematic review and meta-analysis 7
Higher ADPN levels are associated with a lower risk of T2DM across diverse populations and is currently the strongest and most consistent biomarker of T2DM risk assessment.
2. BMJ Open Diabetes Research & Care (2016): Adiponectin levels predict prediabetes risk: The pathobiology in a biracial cohort (POP-ABC) study 8
Baseline ADPN levels were inversely related to the risk of pre-diabetes among the healthy African Americans and European Americans with a parental history of T2DM enrolled on the POP-ABC study. Despite gender and ethnic difference, this predictive relationship was evident.
The most commonly observed component of metabolic syndrome (MetS) is abdominal obesity. MetS encompasses several conditions including: hypercholesterolemia, triglyceridemia, glycaemia, hypertension, abdominal obesity and dyslipidaemia. The prevalence of MetS is 31% and is associated with a 1.5-fold increased risk of all-cause mortality, a 2-fold increased risk of coronary heart disease (CHD) and cerebrovascular accident (CVA), and a 5-fold increased risk of T2DM 9, 10, 11.
Adiponectin has been identified as a glucose regulator and lipid homeostasis through its insulin sensitising properties which are associated with MetS.
1. Nutrition and Diabetes (2011): Serum adiponectin level is not only decreased in metabolic syndrome but also in borderline metabolic abnormalities 12
Decreasing ADPN levels begins at an early stage before the onset of hypertension, diabetes, metabolic syndrome or dyslipidaemia. Moreover, in those with metabolic abnormalities / physiological abnormalities, ADPN is an important biomarker for the risk assessment of atherosclerosis, both independently and as a reflection of the accumulation of AVF.
2. Cardiovascular Diabetology (2015): Role of adiponectin and free fatty acids on the association between abdominal visceral fat and insulin resistance 13
Subjects with high abdominal visceral fat (AVF) or low ADPN had a 3-fold increased risk of insulin resistance. The combination of low ADPN with high AVF doubled this probability.
It has been recognised that mRNA expression of the ADPN gene and the section of high molecular weight (HMW) oligomeric ADPN are impaired in adipose tissue of obese patients. Epidemiological studies undertaken in different ethnic groups established that low ADPNn levels, especially in HMW oligomer, is an independent risk factor for CVD 14. Fig. 2 illustrates the pleiotropic role of adiponectin in the cardiovascular system.
1. PLOS ONE (2013): Adiponectin provides additional information to conventional cardiovascular risk factors for assessing the risk of atherosclerosis in both genders 15
The risk of carotid intima media thickness (CIMT) inversely correlates with ADPN levels in both genders. ADPN testing is a significant marker of atherosclerosis and can provide additional information in the assessment of atherosclerotic risk in both genders, independent of conventional cardiovascular risk factors.
2. European Journal of Preventive Cardiology (2015): Adiponectin, type 2 diabetes and cardiovascular risk 16
Increasing ADPN levels in plasma is associated with a decreased risk of T2DM and subsequently, a reduced risk of CVD.
Fig. 2. The pleiotropic role of adiponectin in the cardiovascular system 14
Excess body fat is not only associated with T2DM and CVD, but also with various types of malignancies. Many cancer cell lines express ADPN receptors, and adiponectin in vitro limits cell proliferation and induces apoptosis. Evidence exists supporting ADPN as a novel risk marker in the diagnosis and prognosis of cancer 14. Fig. 3 illustrates the association between obesity, low levels of adiponectin and cancer progression.
1. Medicine (2018): Serum adiponectin in breast cancer: A meta-analysis 19
The meta-analysis indicates an intriguing association between low levels of ADPN and an increased risk of breast cancer. Moreover, ADPN has the potential to serve as a biomarker of breast cancer risk and aid in the identification of those at a high-risk of developing breast cancer.
Fig. 3. The association between obesity, low adiponectin levels and cancer progression 15
2. International Brazilian Journal of Urology (2019): Role of adiponectin in prostate cancer 20
Numerous studies analysed in the review support ADPN as a protective and safe factor to prevent the progression of prostate cancer.
“CVDs are the number 1 cause of death globally: more people die annually from CVDs than from any other cause”. In 2015, roughly 17.7 million people died from CVD, representing 31% of all global deaths: 7.4 million were due to coronary heart disease and 6.7 million were due to stroke. (WHO, 2017)
Cardiac health and regular cardiovascular screening is important to enable risk factors to be detected in their earliest stages. There are a few factors which contribute to CVD. These include: smoking, unhealthy diet, excessive alcohol consumption, low physical activity levels. Whilst there are only a few factors contributing to CVD, these can be maintained by the patient through living a healthy lifestyle including: quitting smoking, consuming no more than the recommended allowance of alcohol, cutting out junk food, and exercising for 30 minutes a day, 3 – 5 days a week. In a perfect world, this would be easy and CVD would not be a global problem. However, due to busy lifestyles, cravings, reduced willpower, and convenience, not all individuals in today’s world will be able to avoid CVDs. Therefore, it is vitally important that individuals are tested for CVDs to detect them in the earliest stages to reduce damage, prevent further damage, or even death. Furthermore, many individuals suffer from inherited cardiac risk factors, which stresses the need for accurate testing of both traditional and novel cardiac risk biomarkers.
Randox offer the complete solution to cardiac risk assessment including: RX analysers, traditional and novel reagents, internal quality control (Acusera), and external quality control (RIQAS).
Randox has developed the RX series range of clinical chemistry analysers for high-quality semi-automated and fully automated testing. Choose between the RX misano, RX monaco, RX daytona+, RX imola, and the RX modena depending on the throughput of your laboratory. The RX series offers a suitable analyser for your laboratory’s needs. For more information on the Randox RX series, please click here or email firstname.lastname@example.org
As previously mentioned, early assessment of cardiac risk is vital. Randox offer a range of novel risk biomarkers for both very early and the genetic assessment of cardiac risk.
The niche Adiponectin assay allows for the early assessment of CVD. Adiponectin levels are inversely correlated with abdominal visceral fat which has proven to be a strong predictor of T2DM. Body-Mass Index (BMI) is a common method for determining which patients are classified as underweight, healthy, overweight or obese, however, BMI does not take into account gender, ethnicity or activity levels. For example, measuring the BMI of athletes who have a high BMI due to muscle weighing heavier than fat would classify them as obese which is inaccurate. Measuring adiponectin levels is therefore a much more reliable indicator of at-risk patients compared to BMI.
LDL cholesterol is often referred to as the ‘bad cholesterol’. High concentrations of LDL-cholesterol is considered to be the most important clinical predictor, of all single parameters, with respect to coronary atherosclerosis. However, sLDL is a smaller, more dense subfraction of LDL-cholesterol. sLDL particles more readily permeate the inner arterial wall and are more susceptible to oxidation. Individuals with a predominance of sLDL have a 3-fold increased risk of myocardial infarction. Measurement of sLDL allows the clinician to get a more comprehensive picture of lipid risk factors and tailor treatment accordingly.
Elevated levels of Lp(a) are considered to be both a casual risk factor and independent genetic marker of atherosclerotic disorders. The major challenge associated with Lp(a) measurement is the size variation of apo(a) within Lp(a). Dependent upon the size of apo(a) in the assay calibrator, many assays under or overestimate apo(a) size in the patient sample. Numerous commercially available products suffer apo(a) size related bias, resulting in an over estimation of Lp(a) in samples with large apo(a)molecules and an under estimation in samples with small apo(a) molecules. The antibody used in the Randox method detects the complete Lp(a) molecule providing accurate and consistent results. This was proven by the IFCC who developed a gold standard ELISA reference assay and compared 22 commercially available tests. The Randox Lp(a) method displayed the least (minimal) amount of apo(a) size related bias, proving it be a superior offering.
HDL3 Cholesterol is a smaller and more dense subfraction of the HDL particle. HDL is the scavenger of cholesterol within arterial walls and the levels of HDL3 is too low, the ability to remove this cholesterol is reduced. Therefore, it is widely accepted that there is an inverse correlation between HDL3 and CVD risk.
Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers. Contact us to enquire about your specific analyser.
Acusera – Internal Quality Control
The Acusera cardiac controls have been designed to cover a wide range of cardiac markers at clinical decision levels, eliminating the extra expense of an additional low level control. The controls are available in a both liquid ready-to-use and lyophilized formats making them ideal for all situations and manufactured from 100% human serum a matrix similar to that of the patient is guaranteed. For more information on the Randox Acusera internal quality control, please click here or email email@example.com
RIQAS – External Quality Control
The RIQAS Liquid Cardiac EQA programme is designed to monitor the performance of up to 9clinically significant cardiac markers including: CK-MB mass, D-dimer, Digoxin, homocysteine, hsCRP, myoglobin, NT proBNP, troponin I, and troponin T. RIQAS is ISO/IEC 17043 accredited and allows the registration of up to five instruments at no extra cost. All samples are 100% human serum and provided in a liquid ready-to-use format for enhanced convenience. Submit your results bi-weekly and view reports online via RIQAS.Net. For more information on RIQAS, the world’s largest international EQA scheme, please click here or email firstname.lastname@example.org
For further information, please contact the Randox PR team via email: email@example.com or phone 028 9442 2413
BMI is commonly used to assess how healthy we are, but how reliable is BMI as a measure of health?
Body Mass Index (BMI) is frequently used to measure health. This involves comparing your weight in relation to your height to give you an indication of your weight status. It will categorise you as being either underweight, overweight, obese or healthy. Although widely used, BMI is often argued to be inaccurate as it doesn’t take into account muscle mass, age, sex, ethnicity and fitness levels. Even with a ‘healthy’ BMI, you could still be at risk of developing illnesses such as heart diseases, cancer and type 2 diabetes.
A more accurate indicator of health is the waist-to-hip ratio, found by dividing waist width by hip width. A wider waist circumference gives you an indication of total body fat as well as the level of visceral fat. Visceral fat is essentially body fat stored within the abdominal cavity; the internal fat that surrounds the organs.
There is a growing body of research which suggests that visceral fat or so-called ‘belly fat’ is the most dangerous type of fat, with it being linked to chronic diseases such as cancers, heart diseases and diabetes-related illnesses. Furthermore, visceral fat levels have even been suggested to predict type 2 diabetes, although this is a warning sign more commonly displayed in women rather than men.
Factors which contribute to increased visceral fat levels include lifestyle habits such as stress and exercise habits; dietary contributors and demographics such as age, ethnicity and even gender.
Presence of a blood analyte (or component) called adiponectin is closely linked with visceral fat levels. An ever-increasing number of clinical studies highlight that lower levels of adiponectin indicate higher levels of visceral fat. Adiponectin levels can be tested to give you an accurate measurement of the level of visceral fat you are carrying.
In short, monitoring visceral fat levels is a much more accurate measure of risk of a number of diseases including cancers, CVD and diabetes than BMI; which does not take into account muscle mass, age, sex, ethnicity and fitness level. A true measure of visceral fat levels can be measured using the adiponectin test, which can be requested from your doctor today!
For health professionals
Adiponectin is an adipokine exclusively secreted by adipocytes which has an important role in a number of metabolic processes such as fatty acid oxidation and glucose regulation.
Randox Adiponectin assay is an automated biochemistry assay for the measurement of adiponectin in serum or plasma, and is available for use on most biochemistry analysers. For more information, please contact us: firstname.lastname@example.org.