Abstract: AIM:To determine the circulatory distribution of hormone adiponectin (APN) multimers and their relationships with cardiovascular disease (CVD)-related biochemical indicators in patients with hypercholesterolemia (HC). METHODS: A total of 148 age- and body mass index (BMI)-matched male patients with HC (80 with CVD and 68 without CVD) and 84 healthy male controls were enrolled. Diabetes mellitus, hypertension, nephropathy and smoking habit constituted exclusion criteria. RESULTS: Both high molecular weight (HMW) and medium molecular weight (MMW) forms of APN significantly increased in HC without CVD (HMW: 4.98±0.87 vs. 2.51±0.33 in controls, P<0.01; MMW: 2.20±0.36 vs. 1.01±0.15 in control, P<0.01) and were comparable to those in patients with HC-related CVD (HCVD). In comparison to other APN oligomers, HMW was most closely associated with the HCVD-related biochemical factors: total cholesterol (r=0.345, P<0.05), high-density lipoprotein cholesterol (HDLc, r=0.325, P<0.05) and uric acid (UA, r=-0.472, P<0.01). Additional analysis via binary logistic regression suggested HMW APN was an independent predictor of risk for HCVD (OR, 8.434; P=0.018). CONCLUSION: Reduced HMW isoform concentrations may predict the possibility of cardiovascular complications in HC patients.