Background: Adiponectin is insulin-sensitizing, anti-inflammatory, and anti-atherogenic protein released by adiopocytes. However, the data addressing the implications of plasma adiponectin in coronary artery disease (CAD) are so far inconsistent. We tried to investigate the association of plasma adiponectin concentrations with the presence of CAD. Methods: We sought to evaluate a total of 127 patients undergoing coronary artery angiogram in a cross-sectional study including clinical and laboratory investigations. The patients were divided into 2 groups according to the presence or absence of CAD (defined by ���50% stenosis in major coronary vessels). Results: Plasma adiponectin concentrations were significantly higher in patients with CAD (N=82) than in those without CAD (N=45) (6.0 짹 7.1 vs 3.3 짹 3.8 關g/ml, P=0.006). This association remained significant after adjustment for the sex, age (���65 years), diabetes mellitus, hypertension, hyperlipidemia, obesity (Body mass index ���25 kg/m2), and current smoker (P=0.034), but it was lost after adjustment for additional chronic kidney disease (estimated glomerular filtration rate <60 ml/min/1.73m2 by MDRD formula) (P=0.092). Conclusion: The paradoxical increase of plasma adiponectin concentrations observed in patients with CAD may be a counter-regulatory response. Further clinical investigations are needed to determine the real implications of plasma adiponectin in patients with CAD and/or renal insufficiency.