High serum adiponectin concentration and low body mass index are significantly associated with increased all-cause and cardiovascular mortality in an elderly cohort, “adiponectin paradox”: The Korean Longitudinal Study on Health and Aging (KLoSHA)

Abstract

BackgroundThe relationship between adiponectin concentration and mortality is unclear. We examined whether serum adiponectin concentration is associated with all-cause and cardiovascular mortality in elderly Asians. MethodsWe analyzed the data for community-dwelling adults ≥65years of age (439 men and 561 women) who were enrolled in the Korean Longitudinal Study on Health and Aging (KLoSHA) cohort in prospective manner. The baseline serum total and high molecular weight adiponectin were measured using an enzyme-linked immunosorbent assay. Using Cox regression, we determined the associations between serum adiponectin concentration and all-cause and cardiovascular mortality after adjusting for well-known cardiovascular risk factors. ResultsOver a mean follow-up time of 6.2years, 222 individuals died, and 52 deaths (23.4%) were by cardiovascular disease. After adjusting confounding factors, elevated baseline serum adiponectin concentration was independently associated with all-cause mortality (adjusted hazard ratio [HR] 1.38; 95% confidence interval [CI] 1.17–1.64) and cardiovascular mortality (HR 1.50; 1.06–2.14). We evaluated the effect modification by baseline body mass index (BMI). High serum adiponectin and low BMI were synergistically associated with increased all-cause mortality (HR 6.25; 3.08–12.71) and cardiovascular mortality (HR 13.94; 1.82–106.58). ConclusionsHigher serum adiponectin concentration was associated with increased all-cause and cardiovascular mortality in community-dwelling elderly Asian population. Our data supported the recent theory so called “adiponectin paradox”. This relationship was strengthened when combined with low BMI. We suggest that measurement of adiponectin concentration and BMI together could be an additional predictive marker of survival among elderly adults.