Abstract 18168: Plasma Free Fatty Acids, Fatty Acid-Binding Protein 4, and Mortality in Older Adults in the Cardiovascular Health Study

Abstract

Background: Plasma free fatty acids (FFA) are important in energy homeostasis and fatty acid-binding protein 4 (FABP4) is a key cytoplasmic chaperone of fatty acids. While both FFA and FABP4 have been associated with cardiovascular risk factors and cardiovascular events, limited and inconsistent data are available on the relation of these biomarkers with cardiovascular and total mortality. Methods and Results: We studied 4,707 participants with plasma FFA and FABP4 measured at baseline (1992-1993) in the Cardiovascular Health Study. The mean age of the participants was 75 (range 64-98) and 58.3% were women. Over a median follow-up of 11.8 years, 3,555 of the participants died. Cox proportional hazard models were used to estimate hazard ratios (HR) for mortality. After adjustment for age, sex, race, clinic, education, body-mass index, cystatin c, albumin, physical activity, alcohol intake, smoking, hormone replacement therapy in women, self-reported health status, systolic blood pressure, LDL cholesterol, HDL cholesterol, hypertensive medication, and lipid-lowering medication, FFA (HR: 1.14, 95% CI 1.09-1.18 per SD [0.2 mEq/L] higher FFA) but not FABP4 (HR: 1.04 (95% CI: 0.98-1.09 per SD [18.9 ng/mL] higher FABP4) levels were associated with total mortality. In a cause-specific mortality analysis, higher concentrations of FFA were associated with a greater risk of death due to cardiovascular and certain non-cardiovascular causes (Table 1). Conclusion: In a cohort of community-dwelling older individuals, elevated plasma concentrations of FFA (but not FABP4) were associated with cardiovascular and non-cardiovascular mortality.