Abstract: AIM: To explore the relationship between serum adiponectin concentration and the severity of coronary artery lesions. METHODS: One hundred and thrity six coronary heart disease (CHD) patients identified by coronary angiography were recruited in this study. Patients were divided into three groups according to their coronary angiographic characteristics and clinical histories: 60 acute coronary syndrome patients, 36 stable angina patients and 40 negative control patients. According to the modified Gensini scores, the CHD patients were subdivided into Gensini score ≥30 group and <30 group and further divided by single-, double- or triple-vessel coronary lesions. Serum adiponectin concentrations of the subjects were measured by double-antibody sandwich ELISA method. RESULTS: Serum adiponectin concentrations in the CHD group (ACS and SAP) ［(7.2±2.6) mg/L, (8.4±3.2) mg/L］ were significantly lower than those in the control group ［(19.5±2.5) mg/L, P<0.01］. Adiponectin concentration increased with the development of atherosclerosis. The adiponectin level of Gensini score 30 was lower than that of Gensini score <30 ［(7.0±1.6) mg/L vs.(13.7±6.7) mg/L, P<0.01］. A significant difference in serum adiponectin concentrations was observed between patients with triple-vessel and single-vessel lesions ［(7.5±2.8) mg/L vs.(13.2±5.8) mg/L, P<0.01］ and between patients with triple-vessel and double coronary lesions ［(7.5±2.8)mg/L vs.(10.7±4.8)mg/L, P<0.05］. However, no significant difference was observed in serum adiponectin concentrations between patients with double and single coronary lesions. CONCLUSION: Adiponectin concentration is significantly correlated with the severity of coronary artery lesion and the number of stenosed coronary vessels. Serum adiponectin concentration level can be used as an indicator for evaluating the severity of coronary artery lesions.