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BACKGROUND
We investigated whether low serum adiponectin concentrations are able to predict the future development of type 2 diabetes and metabolic syndrome. METHODS: This was a prospective cohort study, which included 372 elderly Koreans that participated in the South-West Seoul (SWS) study, conducted in 1999 and 2002 in Seoul, Korea. Fasting and post-challenge 2-hour plasma glucose, body mass index (BMI), waist-to-hip ratio (WHR), blood pressure, lipid profiles, and serum adiponectin data were examined. RESULTS: Adiponectin concentrations obtained in 1999 and 2002 were highly correlated (r = 0.63, P < 0.0001), and the three-year within-person variation of the adiponectin concentrations was not significant (P=0.61). The serum adiponectin level was closely correlated with metabolic syndrome; negatively with BMI, WHR, blood pressure, triglyceride and blood glucose, and positively with HDL cholesterol. Subjects with metabolic syndrome showed lower serum adiponectin concentrations than those without (P < 0.0001). The baseline adiponectin levels were found to be correlated with subsequent changes in the WHR, LDL cholesterol, and fasting and post-load 2h glucose over the 3-year period, after adjusting the baseline values. A multiple logistic regression analysis showed that lower baseline serum adiponectin concentrations were significantly associated with the developments of type 2 diabetes and the metabolic syndrome after adjusting for age, gender, obesity, history of impaired fasting glucose or impaired glucose tolerance, hypertension and dyslipidemia. CONCLUSION: Reduced concentrations of adiponectin were found to be independently associated with increase risks of both type 2 diabetes and metabolic syndrome in elderly Koreans