Unlike most other adipokines, circulating adiponectin concentration is higher with lower adiposity.2 In prospective observational studies in humans using multivariable regression, higher circulating adiponectin is associated with lower risk of type 2 diabetes mellitus,3 hepatic dysfunction,4 and metabolic syndrome5 but higher mortality in patients with kidney disease, heart failure, previous cardiovascular disease, or general elderly cohorts6–9; this different direction of effect between risk of incident disease and mortality among high-risk groups has been called the adiponectin paradox.10 The gene discussed is ADIPOQ; the disease is kidney disorder.