Although some aspects of the complicated relationship between adiponectin and health outcomes are still unresolved, based on the findings so far, we would like to propose a hypothesis that high adiponectin levels in centenarians might reflect the compensatory response to maintain metabolic homeostasis and to counteract oxidative stress and inflammation, which are relevant in catabolic states, such as sarcopenia and chronic heart failure (Figure 1). Here, ADIPOQ is linked to congestive heart failure.