Abstract 12229: Adipokines Are Linked to Heart Failure Through Metabolic Risk-Dependent and Independent Pathways: The Atherosclerosis Risk in Communities (ARIC) Study

Abstract

Introduction: Adipokines have metabolic effects and laboratory studies also suggest direct effects of adipokines on the myocardium. However, there are no population-based studies examining heart failure (HF) risk with multiple adipokines in concert. Methods: We conducted a prospective analysis of ARIC Visit 2 (1990-92) participants without HF. Adipokines were categorized into quartiles. “Abnormal” adipokine levels were defined as the top quartile for leptin, resistin, and visfatin, and the bottom quartile for adiponectin and apelin. We compared the prevalence of adipokine abnormalities across body mass index (BMI) categories: normal weight (BMI 18.5-<25 kg/m 2 ), overweight (BMI 25-<30 kg/m 2 ), obesity (BMI 30-<35 kg/m 2 ) and severe obesity (BMI ≥35 kg/m 2 ). We used Cox regression to examine associations for each adipokine and the number of abnormal adipokines with incident HF. Results: Among 10,725 participants (mean age 58, 55% female, 22% Black), higher prevalences of multiple (≥2) adipokine abnormalities were seen with higher BMI (56% of those with severe obesity vs 15% of normal weight). After adjusting for confounders (Table), higher adiponectin and apelin were associated with lower HF risk (Q4 vs. Q1 HR: 0.70, 95%CI: 0.62-0.79; HR: 0.87, 95%CI: 0.78-0.97), and higher leptin and resistin with higher HF risk (Q4 vs. Q1 HR: 2.06, 95%CI: 1.78-2.38; HR: 1.31, 95%CI: 1.17-1.46). Visfatin was not associated with HF. Results were similar when stratified by obesity (BMI ≥30 kg/m 2 ). For leptin and adiponectin, HF associations were attenuated by adjusting for metabolic risk factors, but not for apelin and resistin (Table). Having more adipokine abnormalities was linked to progressively higher HF risk (For 4 vs 0 abnormalities HR: 2.92, 95% CI: 1.95-4.30). Conclusions: Adipokines are linked to HF risk, with some associations mediated by metabolic risk factors and others independent of metabolic risk. Adipokines may be a key mechanistic link between adipose tissue and HF.