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Objectives To investigate the relationship between plasma adiponectin level and coronary heart disease (CHD), and some established cardiovascular risk factors and to probe its probable pathogenesis which adiponectin results in CHD.Methods The levels of plasma adiponectin, fasting plasma insulin (FINS), C-reactive protein (CRP) and P-selectin were measured by ELISA, plasma ET-1 was measured by radioimmunoassay (RIA) in 75 male patients with CHD and 30 healthy male people. Body mass index (BMI), waist / hip ratio (WHR) and insulin resistance index (Homa-IR) were calculated respectively. Results (1)The plasma adiponectin levels in CHD group were lower compared with control group[ (5.18±2.57)mg / L vs(8.94±2.59)mg / L, P＜0.001 ], there was no significant difference of plasma adiponectin levels in CHD sub-groups (P ＞ 0.05). (2)Based on multinominal stepwise logistic regression analysis, adiponectin was one of significant and independent risk factors for CHD. (3) Multivariate liner stepwise regression analysis showed that adiponectin had significant correlation with BMI and TG, BMI and TG were independent factors influencing on plasma adiponectin levels. (4) Pearson correlation analysis indicated plasma adiponectin levels were inversely related to FINS levels , Homa-IR, CRP, P-selectin and ET-1. Conclusions (1)Plasma adiponectin levels are lower in CHD patients compared the control subjects. there are no significant difference of plasma adiponectin levels in patients with SAP, UAP and AMI. (2) Plasma adiponectin levels are relative with CHD. Hypoadiponectinemia is an independent risk factor for CHD. (3)Established cardiovascular risk factors such as BMI and TG have an obvious influence on adiponectin. (4)The probable pathogenesis by which adiponectin involves in CHD is suggested that adiponectin relates to insulin resistance, inflammatory reaction and dysfunction of vessel endothelium.