title: Relations of plasma total and high-molecular-weight adiponectin to new-onset heart failure in adults ≥65 years of age (from the Cardiovascular Health study).
abstract: Adiponectin exhibits cardioprotective properties in experimental studies, but elevated levels have been linked to increased mortality in older adults and patients with chronic heart failure (HF). The adipokine's association with new-onset HF remains less well defined. The aim of this study was to investigate the associations of total and high-molecular weight (HMW) adiponectin with incident HF (n = 780) and, in a subset, echocardiographic parameters in a community-based cohort of adults aged ≥65 years. Total and HMW adiponectin were measured in 3,228 subjects without prevalent HF, atrial fibrillation or CVD. The relations of total and HMW adiponectin with HF were nonlinear, with significant associations observed only for concentrations greater than the median (12.4 and 6.2 mg/L, respectively). After adjustment for potential confounders, the hazard ratios per SD increment in total adiponectin were 0.93 (95% confidence interval 0.72 to 1.21) for concentrations less than the median and 1.25 (95% confidence interval 1.14 to 1.38) higher than the median. There was a suggestion of effect modification by body mass index, whereby the association appeared strongest in participants with lower body mass indexes. Consistent with the HF findings, higher adiponectin tended to be associated with left ventricular systolic dysfunction and left atrial enlargement. Results were similar for HMW adiponectin. In conclusion, total and HMW adiponectin showed comparable relations with incident HF in this older cohort, with a threshold effect of increasing risk occurring at their median concentrations. High levels of adiponectin may mark or mediate age-related processes that lead to HF in older adults.
authors.affiliation: Department of Medicine, Weill Cornell Medical College, New York, New York.
authors.forename: Maria G
authors.initials: MG
authors.lastname: Karas
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, Washington.
authors.forename: David
authors.initials: D
authors.lastname: Benkeser
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, Washington.
authors.forename: Alice M
authors.initials: AM
authors.lastname: Arnold
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, Washington.
authors.forename: Traci M
authors.initials: TM
authors.lastname: Bartz
authors.affiliation: Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Luc
authors.initials: L
authors.lastname: Djousse
authors.affiliation: Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Mukamal
authors.affiliation: Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California; Division of Nephrology, Department of Medicine, University of California, San Diego, San Diego, California; Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California, San Diego, San Diego, California.
authors.forename: Joachim H
authors.initials: JH
authors.lastname: Ix
authors.affiliation: Division of Geriatrics and Clinical Gerontology, National Institute on Aging, Bethesda, Maryland.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Zieman
authors.affiliation: Cardiovascular Health Research Unit, Departments of Medicine and Epidemiology, University of Washington, Seattle, Washington.
authors.forename: David S
authors.initials: DS
authors.lastname: Siscovick
authors.affiliation: Departments of Pathology and Biochemistry, University of Vermont, Colchester, Vermont.
authors.forename: Russell P
authors.initials: RP
authors.lastname: Tracy
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts; Section of Endocrinology, Boston Veterans Affairs Healthcare System, Boston, Massachusetts.
authors.forename: Christos S
authors.initials: CS
authors.lastname: Mantzoros
authors.affiliation: Cardiology Division, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: John S
authors.initials: JS
authors.lastname: Gottdiener
authors.affiliation: Cardiology Division, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: deFilippi
authors.affiliation: Department of Medicine, Albert Einstein College of Medicine, Bronx, New York; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York. Electronic address: jorge.kizer@einstein.yu.edu.
authors.forename: Jorge R
authors.initials: JR
authors.lastname: Kizer
mesh_terms: D052242:Adiponectin / Q000097:blood*; D017668:Age of Onset; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D052242:Adiponectin; D015415:Biomarkers