Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (662 page)

   Higher adiponectin levels are associated with a lower risk of type 2 diabetes across diverse populations, consistent with a dose–response relationship.

   Interpretation

Increased In

   Twofold before a meal and decreases to trough levels within 1 hour after eating

   More than twofold in hemodialysis patients

Decreased In

   Type 2 diabetes mellitus

   Obesity and metabolic syndrome

   Limitations

   Adiponectin exerts some of its weight reduction effects via the brain. This is similar to the action of leptin, but the two hormones perform complementary actions and can have additive effects.

   Due to its important cardiometabolic actions, adiponectin represents a biologic molecule worth being studied as a new emerging biomarker of disease and also as a target for pharmacologic treatments.

Suggested Reading

Li S, Shin HJ, Ding EL, et al. Adiponectin levels and risk of type 2 diabetes: a systematic review and meta-analysis.
JAMA.
2009;302(2):179–188.

ADRENOCORTICOTROPIC HORMONE (ACTH)

   Definition

   ACTH is a polypeptide hormone produced by the anterior pituitary gland that exists principally as a chain of 39 amino acids, with a molecular mass of approximately 4,500 Da. Its biologic function is to stimulate cortisol secretion by the adrenal cortex. ACTH secretion is in turn controlled by the hypothalamic hormone CRF and by negative feedback from cortisol.

   
Normal range:
<46 pg/mL.

   Use