The adiponectin paradox. The adiponectin paradox. Quite unexpectedly, given its salutary effects on glucose metabolism, inflammation, and several atherosclerotic processes reported by basic science studies, adiponectin seems to be a mere marker of reduced insulin resistance and type 2 diabetes, with no pathogenic role on these metabolic abnormalities (as stressed by the dashed arrow). Even more unexpected are reports showing that adiponectin exerts a neutral effect on nonfatal cardiovascular events and, paradoxically, a deleterious role on both all-cause and cardiovascular mortality. Claudia Menzaghi, and Vincenzo Trischitta Diabetes 2018;67:12-22 ©2018 by American Diabetes Association