Circulating Adiponectin Levels and Mortality in Elderly Men With and Without Cardiovascular Disease and Heart Failure

Abstract

Background: High adiponectin levels have been associated with reduced cardiovascular risk but have been shown to predict mortality in those at high risk for vascular disease. We examined the relationship between adiponectin levels and mortality in older men with and without diagnosed cardiovascular disease (CVD) and heart failure. Methods: Prospective study of 4046 men aged 60 to 79 years drawn from general practices in 24 British towns and followed up for a mean of 6 years, during which 734 deaths occurred. The men were divided into the following groups according to the presence of physician-diagnosed CVD and heart failure: (1) those with no CVD or heart failure; (2) those with CVD but without heart failure; and (3) those with heart failure (with or without CVD). Results: After adjustment for a wide range of baseline characteristics, adiponectin levels were positively associated with significantly increased all-cause and CVD mortality in men with no diagnosed CVD or heart failure (top third vs bottom third adjusted relative risk, 1.55 [95% confidence interval (CI), 1.19-2.02; P=.002 for trend] vs 1.53 [95% CI, 1.03-2.27; P=.02 for trend]), as well as in men with diagnosed heart failure ([adjusted relative risk, 2.37 [95% CI, 0.64-8.79; P=.04 for trend] vs 3.43 [95% CI, 0.54-21.70; P =.008 for trend]). No association was seen in those with diagnosed CVD without heart failure. Adjustment for weight loss and renal function made minor differences to these relationships. Conclusions: In older men, high adiponectin levels are associated with increased all-cause and CVD mortality in those with heart failure and those free of CVD. Such observations suggest that adiponectin levels may reflect a balance of both protective and harmful factors.

Circulating adiponectin levels associate with inflammatory markers, insulin resistance and metabolic syndrome independent of obesity

“…Interventions that enhance adiponectin secretion or action may therefore have potential for treatment of metabolic and vascular disease, although the clinical evidence for adiponectin being protective against cardiovascular disease is conflicting. 38 At any rate circulating adiponectin level is a strong risk marker for MetS independent of measures of adiposity.…”

Gene Expression of Adiponectin Receptors in Human Visceral and Subcutaneous Adipose Tissue Is Related to Insulin Resistance and Metabolic Parameters and Is Altered in Response to Physical Training

“…It was recently shown that in elderly men, high adiponectin levels are associated with increased all-cause and cardiovascular disease mortality (22). However, subgroup analyses in individuals aged Ͼ60 years revealed similar associations of adiponectin receptor gene expression with insulin resistance and obesity compared with younger subjects.…”

Muscle loss and obesity: the health implications of sarcopenia and sarcopenic obesity

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