Adipokines may serve as an important etiologic link between atherosclerosis and obesity. Because adipose tissue is one site of action of the lipid-lowering drug niacin, we investigated whether niacin treatment would affect not only lipids but also adipokines. Twenty-four patients were treated with extended-release niacin. During the first 4 weeks the daily dose was increased at weekly intervals from 375 to 1000 mg, which was maintained for 4 weeks. Thereafter, the dose was 1500 mg for another 6 weeks. Adiponectin increased by 54% and 94%, respectively, resistin was lowered only moderately, and leptin not at all. Because adiponectin has repeatedly been shown to be negatively associated with atherosclerotic risk, its pronounced increase may bring about additional atheroprotection by niacin beyond its improvement in lipids.