We found that the association between periaortic fat and aortic dimensions was not likely mediated via circulating systemic levels of adiponectin or resistin, which have been shown to be associated with AAA.2,21 We cannot rule out that resistin and other mediators secreted locally by adipocytes and activated macrophages may promote local effects on the aorta that are not measurable in the systemic circulation. This evidence concerns the gene ADIPOQ and triple-A syndrome.