Provided is a novel drug which has adiponectin receptor affinity and agonist effects, and which is useful in the prevention or treatment of metabolic syndrome, particularly metabolic syndrome accompanied by obesity and diabetes, and arteriosclerosis, etc. A novel spiro compound represented by formula (I) (where Z1, X, L1, L2, E, R6, R7, m, n, and T are as defined in the text), tautomers of the compound, or pharmaceutically acceptable salts thereof are provided.本發明係以提供具有脂聯素受體親和性及促效劑作用，對於代謝症候群(metabolic syndrome)，特別為肥胖或糖尿病所引起的代謝症候群(metabolic syndrome)、及動脈硬化等預防或治療上有用之新穎醫藥為課題。本發明為提供一種式(I)(式中的Z1、X、L1、L2、E、R6、R7、m、n、T由本文中所定義)所示新穎螺環化合物、該化合物的互變異構物，或其醫藥上可被接受的鹽者。
