Adiponectin in patients with community-acquired pneumonia: a prospective cohort study

Abstract

<b>Background:</b> Adiponectin is secreted by adipocytes and reduces pulmonary inflammation and mortality in experimental mice models of sepsis. This study aimed to investigate the association between serum (s)-adiponectin at admission and 90-day mortality (primary outcome), intensive care unit (ICU) admission, length of stay (LOS), and 90-day readmission in patients with community-acquired pneumonia (CAP). <b>Methods:</b> In a prospective cohort study of 502 hospitalised CAP patients, s-adiponectin was measured within 24 hours of admission. Multivariate logistic and linear regression analyses, adjusted for age, sex, body mass index (BMI) and c-reactive protein (CRP) levels, were used to investigate the association between adiponectin and the primary and secondary outcomes. <b>Results:</b> Each 1 µg/mL increase in s-adiponectin was associated with an increased risk of 90-day mortality (OR 1.02, 95% CI [1.00 1.04]) and 90-day readmission (OR 1.02, 95% CI [1.01, 1.04]) in models adjusted for age and sex. The associations between s-adiponectin and 90-day mortality and 90-day readmission were not significant after further adjustment for BMI and CRP. A 1-year increase in age (OR 1.08, 95% CI [1.04, 1.12]) and male sex (OR 2.31, 95% CI [1.2, 4.61]) were associated with increased, whereas higher BMI was associated with reduced 90-day mortality (OR 0.90, 95% CI [0.83, 0.96)]. CRP did not influence the mortality risk. There was no association between s-adiponectin and ICU admission or LOS. <b>Conclusion:</b> Higher s-adiponectin was associated with increased 90-day mortality and readmission risk in CAP patients, but&nbsp;BMI was a confounder of these associations.&nbsp;High s-adiponectin in CAP patients might reflect low BMI and malnutrition.