Vascular Endothelial Adiponectin Signaling Across the Lifespan

Cardiovascular disease risk increases with age regardless of sex. Some of this risk is attributable to changes in natural hormones throughout the lifespan. The quintessential example of this being the dramatic increase in cardiovascular disease following the transition to menopause. Plasma levels of adiponectin, a "cardioprotective" adipokine released primarily by adipose tissue and regulated by hormones, also fluctuates throughout one's life. Plasma adiponectin levels increase with age in both men and women, with higher levels in both pre- and post- menopausal women compared to men. Younger cohorts seem to confer cardioprotective benefits from increased adiponectin levels yet elevated levels in the elderly and those with existing heart disease are associated with poor cardiovascular outcomes. Here, we review the most recent data regarding adiponectin signaling in the vasculature, highlight the differences observed between the sexes, and shed light on the apparent paradox regarding increased cardiovascular disease risk despite rising plasma adiponectin levels over time.