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  • Response to Letter to the Editor
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Response to the letter of Kawada T on adiponectin and the metabolic syndrome

European Journal of Clinical Nutrition volume 67, page 897 (2013)Cite this article

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The metabolic syndrome (MetS) represents a clustering of risk factors for cardiovascular disease (CVD) and Type 2 diabetes (T2DM).1 Over the years there has been much discussion on this syndrome, ranging from its clinical definition to which factors are solely responsible for its aetiology. While insulin resistance and excessive adiposity play key roles, the pathogenesis of the syndrome is still not well understood.

In a recent review, we found that many traditional and emerging risk factors associated with MetS showed some evidence of exerting their influence through the adipocytokine, adiponectin.2 We raised the question whether adiponectin may be the mechanistic key to the risk of MetS. This view was schematically depicted through a series of unidirectional links between potential risk factors and adiponectin through to systemic inflammation, insulin sensitivity and then MetS.2 We accept that some of these relationships maybe bi-directional, as, for example, insulin resistance may be responsible for increased inflammatory cytokine production3 and vice versa.4, 5, 6 However, we disagree with Kawada’s assertion that all the references we cited did not show evidence of association between interlinked events in that scheme.7 In fact, since the acceptance of our article, further confirmation in favour of the inverse association between adiponectin and systemic inflammation,8, 9, 10 between inflammation and insulin sensitivity11, 12, 13 and between sensitivity and MetS13, 14, 15 has emerged. As stated in the conclusions of our paper, higher quality evidence, possibly through randomised controlled trials, are necessary to cement this putative framework.

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  1. School of Public Health, Curtin University, Perth, Western Australia, Australia

    E K Calton, V Miller & M J Soares

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  1. E K Calton
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Correspondence to M J Soares.

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Calton, E., Miller, V. & Soares, M. Response to the letter of Kawada T on adiponectin and the metabolic syndrome. Eur J Clin Nutr 67, 897 (2013). https://doi.org/10.1038/ejcn.2013.105

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