Adiponectin

Where it comes from

Made in

Fat cells only, in large amounts: it is one of the most abundant hormones in blood

Sent out by

Falls as fat cells enlarge; rises with weight loss and with thiazolidinedione drugs

Acts on

• Liver (less glucose output)
• Muscle (more fat burning)
• Vessels (less inflammation)
• Heart

What it does

• Makes liver and muscle more sensitive to insulin through AMPK
• Low in obesity, type 2 diabetes and coronary disease
• Paradoxically high in heart failure and kidney failure, where it predicts worse outcomes

In medicine

• A research marker; pioglitazone works partly by raising it
• No approved medicine copies it. The hormone is an awkward drug, working as a large multimer that has to be assembled correctly, so the effort has gone into small molecules and short peptides that hit its receptors instead ²

Beyond the body’s own use

• AdipoRon, a small molecule that activates both adiponectin receptors, improved insulin sensitivity and prolonged the shortened life of obese diabetic mice; it has not been tested in people ²
• ALY688, a peptide agonist of the same receptors, has been through a phase 2b/3 trial as eye drops for dry eye disease rather than for metabolic disease
• There is nothing to swallow: adiponectin is a large protein, digested before it reaches the blood, so an “adiponectin booster” can only mean something that raises the body’s own level, as weight loss and the thiazolidinediones do