Abstract 12287: Adipokines and Transitions in Metabolic Risk Over Time: The Atherosclerosis Risk in Communities (ARIC) Study

Abstract

Introduction: Individuals with similar weights have substantial heterogeneity in metabolic risk, a key indicator of cardiovascular disease risk. Additionally, many persons progress from metabolically healthy to metabolically unhealthy status, or regress in metabolic risk, over time. The association of adipokines with transitions in metabolic risk status is unknown. Methods: Among ARIC Visit 2 (1990-92) participants without diabetes, we evaluated the associations of adipokines (adiponectin and leptin; in tertiles) with metabolic risk transitions from Visit 2 to Visit 4 (1996-98; a 6-year interval) among persons with and without obesity using logistic regression. We examined transitions from metabolically healthy (no metabolic syndrome [MetS]) to unhealthy status (MetS, with or without diabetes). Among those with MetS without diabetes at Visit 2, we examined adipokine associations with progression to MetS with diabetes and with regression to metabolically healthy status. Results: Among 7,560 participants, mean age was 57 with 56% female and 17% Black adults. Higher adiponectin levels were associated with about 75% lower risk of progression from metabolically healthy to unhealthy status in those with and without obesity, whereas higher leptin was associated with about 3-fold greater risk of progression (Table, Panel A). Among those with MetS at Visit 2, higher adiponectin was associated with lesser risk of progression to diabetes, and greater likelihood of regression to metabolically healthy status in those with and without obesity (Table, Panel B). Conversely, higher leptin was associated with greater risk of progression to diabetes in those with obesity. Conclusion: Adipokine levels are linked to transitions in metabolic risk status over time among persons with similar weight status. Adipokines may identify individuals at greatest risk of developing metabolic risk factors, who may benefit most from aggressive CVD prevention strategies.