Background
Adiponectin, an essential adipocytokine imparts a key role in the development of metabolic syndrome (MS), a cluster of central adiposity and cardiovascular risk factors. Increased prevalence of MS after menopause has been reported.
Aim
Aims of this study were to find out the associations between serum adiponectin level and MS, as well as its different parameters among postmenopausal women in a rural area of West Bengal. 
Method
This cross-sectional study was conducted among 170 postmenopausal women aged 43 to 70 years; selected randomly from 30 villages of Singur block, field practice area of All India Institute of Hygiene and Public Health (AIIH&PH), West Bengal, India from June’2016 to September’2016. Ethical clearance was obtained from the Ethics Committee of AIIH&PH. Written consent was taken from all the participants before data collection. Serum adiponectin was analysed by Ray Biotech ELISA kit. Blood pressure (BP), waist circumference (WC), fasting blood glucose (FBG), serum triglycerides (TG) and high density lipoprotein cholesterol (HDL-C) were measured using standard procedure. MS was defined as per International Diabetes Federation (IDF), 2005 (for Asian-Indians) criteria. In absence of any cut off for serum adiponectin level, the study subjects were divided into two groups based on the observed median value of serum adiponectin level. Statistical analysis like chi-square test (χ2), Mann Whitney U test (Z value) and spearman’s correlation coefficient (rho) were calculated using SPSS software, version 20.0. P value less than 0.05 was considered as statistically significant.
Results
Prevalence of metabolic syndrome was 55.3%. Median adiponectin level was found to be 9.72 μg/ml with a range from 1.03 to 92.2 μg/ml.
Adiponectin value lower than median was observed among 62.8%, 54.7%, 54.3%, 53.7% , 58.5% and 60% postmenopausal women diagnosed with metabolic syndrome, central adiposity, hyperglycaemia, hypertriglyceridaemia, low HDL-C and hypertension, respectively. Significant statistical association between metabolic syndrome, central adiposity and hypertension with adiponectin level was found (χ2 = 13.7; p< 0.05, χ2 = 11.1; p<0.05 and χ2 = 12.5; p<0.05 respectively). No such association was established between hyperglycaemia, hypertriglyceridaemia and low HDL-C with adiponectin level.
Adiponectin decreased with increase in WC(≥80 cm), FBG(≥100 mg/dl), triglyceride(≥150 mg/dl) level, systolic blood pressure (SBP)  (≥130 mm of Hg) and diastolic blood pressure (DBP) (≥85 mm of Hg) and this difference was found to be statistically significant according to Mann-Whitney U test (z = -15.2, p<0.05; z = -14.5, p<0.05; z = -15.5, p<0.05; z = -15.83, p<0.05 and z = -14.82, p<0.05 respectively). Although negative spearman’s correlation was observed between them but it was not significant statistically (p>0.05). Statistically significant positive correlation was observed between adiponectin and HDL-C (rho = 0.18, p = 0.01) while significant negative correlation was found between adiponectin with SBP and DBP (rho = -0.17, p = 0.01 and -0.19, p = 0.01).
Discussion
More than half (55.3%) of the postmenopausal women was diagnosed with MS in the rural area of West Bengal, India.
Significant statistical association between MS and adiponectin level was observed. While analysing the association between adiponectin levels with individual parameters of MS, we have found statistically significant association between central adiposity and hypertension with adiponectin level.
Our study further shows that adiponectin value decreased significantly with increased central adiposity, hyperglycaemia, hypertriglyceridaemia and hypertension, and decreased HDL-C when the participants were divided into two groups according to normal and abnormal parameters of MS as per IDF criteria.
While considering all the participants, our study revealed a direct and significant relationship between adiponectin and HDL-C as well as an inverse and significant relationship with both SBP and DBP with adiponectin. However, no significant correlation was found between adiponectin and other parameters of MS of the women.
Thus, from our study it can be concluded that,
1.	Adiponectin was found to be associated with MS, central adiposity and hypertension among postmenopausal women of Singur block of West Bengal, India.
2.	Women with central adiposity, hyperglycaemia, hypertriglyceridaemia, hypertension and low HDL-C had significantly lower adiponectin level than their counterparts.
3.	Adiponectin level increased significantly with increase in HDL-C and decrease in SBP and DBP among the participants when taken together. 

Conflict of Interest: None.

Receipt of grants or research support:
Indian Council of Medical Research - Junior Research Fellowship

Association of adiponectin with metabolic syndrome and its parameters among postmenopausal women of West Bengal, India