Change in circulating adiponectin in advanced old age: determinants and impact on physical function and mortality. The Cardiovascular Health Study All Stars Study.
BACKGROUND
Cross-sectional studies show that adiponectin is higher in older than in younger adults but long-term change in adiponectin, its determinants, and its relationship to functional decline or survival in the elderly population have not been evaluated.


METHODS
We investigated predictors of longitudinal change in adiponectin, and the association of this adipokine or its antecedent change with physical deterioration and all-cause mortality in 988 participants in a population-based study who completed examinations in 1996-1997 and 2005-2006, had serial adiponectin measurements and underwent follow-up through June 2009.


RESULTS
Adiponectin level rose significantly during follow-up, but the increase was smaller in blacks, was associated with declining weight or fasting glucose and, in men, lower albumin, and was affected by medications. Adiponectin was independently associated with greater physical decline, but the relationship for adiponectin change was driven by concomitant weight decrease. Both adiponectin and its change independently predicted mortality, even after adjustment for weight change. The association for adiponectin and mortality was observed in whites but not in blacks and only for levels in the upper range (hazard ratio = 1.85, 95% confidence interval = 1.36-2.52 per SD ≥ 20 mg/L), whereas that for adiponectin change was linear throughout in both racial groups (hazard ratio = 1.30, 95% confidence interval = 1.10-1.52 per SD).


CONCLUSIONS
Adiponectin levels increase over time in long-lived adults and are associated with greater physical disability and mortality. Such increases may occur in response to age-related homeostatic dysregulation. Additional investigation is required to define the underlying mechanisms and whether this represents a marker or causal factor for mortality in this age group.
Kizer
Jorge R
JR
Department of Medicine, Weill Cornell Medical College, New York, USA. jok2007@med.cornell.edu
Arnold
Alice M
AM
Strotmeyer
Elsa S
ES
Ives
Diane G
DG
Cushman
Mary
M
Ding
Jingzhong
J
Kritchevsky
Stephen B
SB
Chaves
Paulo H M
PH
Hirsch
Calvin H
CH
Newman
Anne B
AB
D052242:Adiponectin / Q000378:metabolism*; D000367:Age Factors; D000368:Aged; D000375:Aging / Q000378:metabolism*; D000704:Analysis of Variance; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D016014:Linear Models; D008297:Male; D010809:Physical Fitness; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology
D052242:Adiponectin