BackgroundOmentin‐1 is a novel adipokine and is associated with chronic inflammation and cardiovascular diseases. However, it remains unclear whether omentin‐1 levels are associated with diagnostic significance in elderly patients with heart failure with preserved ejection fraction (HFpEF). This study aimed to investigate the correlation between omentin‐1 and HFpEF in Chinese elderly patients.HypothesisOmentin‐1 may be invovled in HFpEF and there may be a difference of omentin‐1 levels between HFpEF and control.Methods217 subjects were selected, including 115 patients with HFpEF and 102 control subjects. Enzyme‐linked immuno sorbent assay (ELISA) was used to detect plasma levels of omentin‐1, tumor necrosis factor‐α (TNF‐α) and interleukin‐6 (IL‐6). The receiver operating characteristics (ROC) curve was used to examine the diagnostic performance of omentin‐1 in HFpEF.ResultsThe levels of omentin‐1 decreased significantly in the HFpEF group (14.02 ± 8.35 vs. 19.74 ± 8.45 ng/mL, p < .001), while NT‐proBNP, IL‐6, and TNF‐α levels were significantly increased in the HFpEF group compared with the control group. Spearman correlation analysis showed that omentin‐1 levels were negatively correlated with E/e' (r = −.340, p < .001). The multivariate logistic regression analysis indicated that omentin‐1 was an independent protective factor for HFpEF (odd ratio = 0.948, 95% confidence interval [CI] 0.905–0.993, p = .025). Omentin‐1 levels were negatively correlated with NT‐proBNP (r = −.273, p < .001) and TNF‐α (r = −.221, p = .001). Diagnostic efficiency by ROC curve analysis in the patients with HFpEF showed that the area under the curve (AUC) for omentin‐1 was equivalent to NT‐proBNP (AUC: 0.734, 95%CI 0.667–0.802; AUC: 0.800, 95%CI 0.738–0.861). Subgroup analysis showed that in the patients between the age of 70 and 80, the predictive capability of omentin‐1 was stronger than NT‐proBNP (AUC: 0.809, 95%CI 0.680–0.937; AUC: 0.674, 95%CI 0.514–0.833).ConclusionsOmentin‐1 levels which were associated with inflammation, were decreased in the HFpEF patients. It could be regarded as a valuable biomarker for the occurrence and development of HFpEF in elderly patients.