Association of plasma adiponectin with pulmonary hypertension, mortality and heart failure in African Americans: Jackson Heart Study

Abstract

Background: Adiponectin is a polypeptide hormone related to obesity, and a known modulator of pulmonary vascular remodeling. Association between plasma adiponectin levels and pulmonary hypertension (PH) has not been studied in African Americans (AAs) who are disproportionately affected by obesity. The relationship between adiponectin and heart failure (HF) and mortality, outcomes associated with PH, is unclear.
Methods: We performed cross sectional and longitudinal analysis to examine if there is an association between plasma adiponectin and PH and associated clinical outcomes, in participants of Jackson Heart Study (JHS). JHS is a prospective observational cohort study of heart disease in AAs from Jackson, Mississippi. 
Results: Of the 3,161 participants included in the study, mean age (SD) was 56.38 (12.61) years, 1,028 were men (32.5%), and mean (SD) BMI was 31.42 (7.05) kg/m2. Median (IQR) adiponectin was 4516.82 (2799.32-7065.85) ng/mL. After adjusting for potential confounders including BMI, higher adiponectin levels were associated with increased odds of PH (adjusted odds ratio per log increment in adiponectin, (1.81; 95% CI, 1.41-2.32). High adiponectin levels were also associated with associated HF admissions (adjusted hazard ratio [HR] per log increment in adiponectin, 1.63, 95% CI, 1.24-2.14) and mortality (adjusted HR per log increment in adiponectin, 1.20; 95% CI 1.02-1.41). 
Conclusions: Elevated plasma adiponectin levels are associated with PH, HF admissions and mortality risk in AAs. High adiponectin levels may help identify an at-risk population that could be evaluated for targeted prevention and management strategies in future studies

Selected adipocytokine concentrations in patients hospitalized for exacerbated chronic heart failure

“…6). The obtained results corroborate data presented in recent publications showing that increased blood ADP concentration is a factor in the poor prognosis in CHF patients [12][13][14][15][16][17]. The association of poor prognosis in CHF patients with higher blood ADP concentration, which should, theoretically, exert cardioprotective action, is known as the "ADP paradox", and is recognized as the result of ADP resistance [16].…”

“…4). In the available articles, data concerning those relationships with regard to ADP, leptin, and TNF-alpha are ambiguous [4,5,[12][13][14][15][16][17]. Despite potential cardioprotective effects of ADP, Mado et al [12] summarize in their review that the adiponectin level gradually increases with the severity of CHF.…”

“…www.journals.viamedica.pl/medical_research_journal Adiponectin (ADP) is the only adipocytokine that is recognized as cardioprotective [12]. It is shown to have anti-diabetic, anti-atherogenic, and anti-inflammatory properties in experimental studies [6][7][8][9], and to regulate cardiac and vascular remodeling [7,13]. Nevertheless, in patients with CHF, the ADP level gradually increases with the severity of the disease and a higher ADP level is a factor of poor prognosis (the "adiponectin paradox").…”

“…Nevertheless, in patients with CHF, the ADP level gradually increases with the severity of the disease and a higher ADP level is a factor of poor prognosis (the "adiponectin paradox"). Nevertheless, as with leptin and TNF-alpha, the outcomes of clinical studies concerning the relationship between blood ADP concentration and cardiovascular risk are ambiguous [12][13][14][15][16][17]. The adiponectin paradox, defined as an increased cardiovascular risk despite cardioprotective ADP properties, can be explained with reference to ADP resistance [16].…”

Plasma adiponectin levels and risk of heart failure, atrial fibrillation, aortic valve stenosis, and myocardial infarction: large-scale observational and Mendelian randomization evidence

“…Previous research has mainly investigated the observational association between plasma adiponectin and heart failure and have mostly suggested a positive association in a total of 5,574 individuals with 780 events 7 , 8 , 10 – 12 . Also, an observational meta-analysis with in total 18,558 individuals and 3,165 events found evidence of a positive association between plasma adiponectin and atrial fibrillation 9 .…”