title: Low adiponectin is associated with diastolic dysfunction in women: a cross-sectional study from the Tromsø Study.
abstract: Heart failure with preserved ejection fraction is closely associated with diastolic dysfunction and related to obesity and female sex. We investigated whether adiponectin, an adipocyte-secreted protein hormone with cardioprotective effects, was associated with indices of diastolic dysfunction, and whether the association was sex dependent.
  
  
  
  We conducted a cross-sectional study on 1165 women and 896 men without diabetes. We stratified the multivariable adjusted logistic regression analyses and the fractional polynomial regression analyses according to sex, with echocardiographic markers of diastolic dysfunction as dependent variables, and adiponectin as the independent variable of interest.
  
  
  
  Decreased adiponectin was associated with higher odds of average tissue Doppler e' < 9 in women (odds ratio [OR] 1.17 per 1 μg/mL adiponectin decrease, 95% confidence interval [CI] 1.04-1.30), but not in men (p for interaction with sex 0.04). Women, but not men, had higher odds of E/e' ratio ≥ 8 with lower adiponectin (OR 1.12 per 1 μg/mL adiponectin decrease, 95% CI 1.02-1.24, p for interaction with sex 0.04). Adiponectin in the lower sex-specific tertile was associated with increased odds of concentric left ventricular hypertrophy in women (OR 2.44, 95% CI 1.03-5.77), but with decreased odds in men (OR 0.32, 95% CI 0.11-0.88, p for interaction with sex 0.002), and decreased odds of eccentric hypertrophy in men only (OR 0.53, 95% CI 0.33-0.88, p for interaction with sex 0.02). Adiponectin in the lower sex-specific tertile was associated with moderately enlarged left atria in women only (OR 1.43, 95% CI 1.01-2.03, p for interaction with sex 0.04). Finally, adiponectin had a non-linear relationship with left ventricular mass in women only, with exponentially increasing left ventricular mass with lower adiponectin levels (p for interaction with sex 0.01).
  
  
  
  Low adiponectin was associated with higher odds of indices of diastolic dysfunction in women, but lower odds of indices of diastolic dysfunction in men. Lower adiponectin was associated with increased left ventricular mass in women only.
authors.affiliation: Metabolic and Renal Research Group, UiT The Arctic University of Norway, N-9037, Tromsø, Norway. jno031@post.uit.no.|Cardiovascular Research Group IMB, UiT The Arctic University of Norway, N-9037, Tromsø, Norway. jno031@post.uit.no.
authors.forename: Jon V
authors.identifier: 0000-0001-7131-0418
authors.initials: JV
authors.lastname: Norvik
authors.affiliation: Department of Cardiology, University Hospital of North Norway, N-9038, Tromsø, Norway.|Cardiovascular Research Group IKM, UiT The Arctic University of Norway, N-9037, Tromsø, Norway.
authors.forename: Henrik
authors.initials: H
authors.lastname: Schirmer
authors.affiliation: Metabolic and Renal Research Group, UiT The Arctic University of Norway, N-9037, Tromsø, Norway.|Cardiovascular Research Group IMB, UiT The Arctic University of Norway, N-9037, Tromsø, Norway.
authors.forename: Kirsti
authors.initials: K
authors.lastname: Ytrehus
authors.affiliation: Metabolic and Renal Research Group, UiT The Arctic University of Norway, N-9037, Tromsø, Norway.|Department of Transplant Medicine, Oslo University Hospital Rikshospitalet, N-0424, Oslo, Norway.
authors.forename: Trond G
authors.initials: TG
authors.lastname: Jenssen
authors.affiliation: Metabolic and Renal Research Group, UiT The Arctic University of Norway, N-9037, Tromsø, Norway.
authors.forename: Svetlana N
authors.initials: SN
authors.lastname: Zykova
authors.affiliation: Department of Community Medicine, UiT The Arctic University of Norway, N-9037, Tromsø, Norway.
authors.forename: Anne E
authors.initials: AE
authors.lastname: Eggen
authors.affiliation: Metabolic and Renal Research Group, UiT The Arctic University of Norway, N-9037, Tromsø, Norway.|Section of Nephrology, University Hospital of North Norway, N-9038, Tromsø, Norway.
authors.forename: Bjørn O
authors.initials: BO
authors.lastname: Eriksen
authors.affiliation: Metabolic and Renal Research Group, UiT The Arctic University of Norway, N-9037, Tromsø, Norway.|Section of Nephrology, University Hospital of North Norway, N-9038, Tromsø, Norway.
authors.forename: Marit D
authors.initials: MD
authors.lastname: Solbu
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler; D005260:Female; D054144:Heart Failure, Diastolic / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013318:Stroke Volume / Q000502:physiology; D015996:Survival Rate / Q000639:trends; D016277:Ventricular Function, Left / Q000502:physiology*; D020257:Ventricular Remodeling
chemical_list: D052242:Adiponectin; D015415:Biomarkers
keywords: Adiponectin; Cardiac remodeling; Cardiovascular disease; Cross-sectional; Diastolic dysfunction; Epidemiology; HFpEF; Heart failure; Women