Higher circulating adiponectin levels are associated with increased risk of atrial fibrillation in older adults

Fima Macheret, Traci M. Bartz, Luc Djousse, Joachim H. Ix, Kenneth J. Mukamal, Susan J. Zieman, David S. Siscovick, Russell P. Tracy, Susan R. Heckbert, Bruce M. Psaty, Jorge Kizer

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background: Adiponectin has cardioprotective properties, suggesting that lower levels seen in obesity and diabetes could heighten risk of atrial fibrillation (AF). Among older adults, however, higher adiponectin has been linked to greater incidence of adverse outcomes associated with AF, although recent reports have shown this association to be U-shaped. We postulated that higher adiponectin would be linked to increased risk for AF in older adults in a U-shaped manner. Methods: We examined the associations of total and high-molecular-weight (HMW) adiponectin with incident AF among individuals free of prevalent cardiovascular disease (CVD) participating in a population-based cohort study of older adults (n=3190; age=74±5 years). Results: During median follow-up of 11.4 years, there were 886 incident AF events. Adjusted cubic splines showed a positive and linear association between adiponectin and incident AF. After adjusting for potential confounders, including amino-terminal pro-B-type natriuretic peptide 1-76, the HR (95% CI) for AF per SD increase in total adiponectin was 1.14 (1.05 to 1.24), while that for HMW adiponectin was 1.17 (1.08 to 1.27). Additional adjustment for putative mediators, including subclinical CVD, diabetes, lipids and inflammation, did not significantly affect these estimates. Conclusions: The present findings demonstrate that higher, not lower, levels of adiponectin are independently associated with increased risk of AF in older adults despite its documented cardiometabolic benefits. Additional work is necessary to determine if adiponectin is a marker of failed counter-regulatory pathways or whether this hormone is directly harmful in the setting of or as a result of advanced age.

Original languageEnglish (US)
Pages (from-to)1368-1374
Number of pages7
JournalHeart
Volume101
Issue number17
DOIs
StatePublished - Sep 1 2015

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Adiponectin
Atrial Fibrillation
Cardiovascular Diseases
Molecular Weight
Brain Natriuretic Peptide
Cohort Studies
Obesity
Hormones
Inflammation
Lipids
Incidence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Higher circulating adiponectin levels are associated with increased risk of atrial fibrillation in older adults. / Macheret, Fima; Bartz, Traci M.; Djousse, Luc; Ix, Joachim H.; Mukamal, Kenneth J.; Zieman, Susan J.; Siscovick, David S.; Tracy, Russell P.; Heckbert, Susan R.; Psaty, Bruce M.; Kizer, Jorge.

In: Heart, Vol. 101, No. 17, 01.09.2015, p. 1368-1374.

Research output: Contribution to journalArticle

Macheret, F, Bartz, TM, Djousse, L, Ix, JH, Mukamal, KJ, Zieman, SJ, Siscovick, DS, Tracy, RP, Heckbert, SR, Psaty, BM & Kizer, J 2015, 'Higher circulating adiponectin levels are associated with increased risk of atrial fibrillation in older adults', Heart, vol. 101, no. 17, pp. 1368-1374. https://doi.org/10.1136/heartjnl-2014-307015
Macheret, Fima ; Bartz, Traci M. ; Djousse, Luc ; Ix, Joachim H. ; Mukamal, Kenneth J. ; Zieman, Susan J. ; Siscovick, David S. ; Tracy, Russell P. ; Heckbert, Susan R. ; Psaty, Bruce M. ; Kizer, Jorge. / Higher circulating adiponectin levels are associated with increased risk of atrial fibrillation in older adults. In: Heart. 2015 ; Vol. 101, No. 17. pp. 1368-1374.
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abstract = "Background: Adiponectin has cardioprotective properties, suggesting that lower levels seen in obesity and diabetes could heighten risk of atrial fibrillation (AF). Among older adults, however, higher adiponectin has been linked to greater incidence of adverse outcomes associated with AF, although recent reports have shown this association to be U-shaped. We postulated that higher adiponectin would be linked to increased risk for AF in older adults in a U-shaped manner. Methods: We examined the associations of total and high-molecular-weight (HMW) adiponectin with incident AF among individuals free of prevalent cardiovascular disease (CVD) participating in a population-based cohort study of older adults (n=3190; age=74±5 years). Results: During median follow-up of 11.4 years, there were 886 incident AF events. Adjusted cubic splines showed a positive and linear association between adiponectin and incident AF. After adjusting for potential confounders, including amino-terminal pro-B-type natriuretic peptide 1-76, the HR (95{\%} CI) for AF per SD increase in total adiponectin was 1.14 (1.05 to 1.24), while that for HMW adiponectin was 1.17 (1.08 to 1.27). Additional adjustment for putative mediators, including subclinical CVD, diabetes, lipids and inflammation, did not significantly affect these estimates. Conclusions: The present findings demonstrate that higher, not lower, levels of adiponectin are independently associated with increased risk of AF in older adults despite its documented cardiometabolic benefits. Additional work is necessary to determine if adiponectin is a marker of failed counter-regulatory pathways or whether this hormone is directly harmful in the setting of or as a result of advanced age.",
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T1 - Higher circulating adiponectin levels are associated with increased risk of atrial fibrillation in older adults

AU - Macheret, Fima

AU - Bartz, Traci M.

AU - Djousse, Luc

AU - Ix, Joachim H.

AU - Mukamal, Kenneth J.

AU - Zieman, Susan J.

AU - Siscovick, David S.

AU - Tracy, Russell P.

AU - Heckbert, Susan R.

AU - Psaty, Bruce M.

AU - Kizer, Jorge

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Background: Adiponectin has cardioprotective properties, suggesting that lower levels seen in obesity and diabetes could heighten risk of atrial fibrillation (AF). Among older adults, however, higher adiponectin has been linked to greater incidence of adverse outcomes associated with AF, although recent reports have shown this association to be U-shaped. We postulated that higher adiponectin would be linked to increased risk for AF in older adults in a U-shaped manner. Methods: We examined the associations of total and high-molecular-weight (HMW) adiponectin with incident AF among individuals free of prevalent cardiovascular disease (CVD) participating in a population-based cohort study of older adults (n=3190; age=74±5 years). Results: During median follow-up of 11.4 years, there were 886 incident AF events. Adjusted cubic splines showed a positive and linear association between adiponectin and incident AF. After adjusting for potential confounders, including amino-terminal pro-B-type natriuretic peptide 1-76, the HR (95% CI) for AF per SD increase in total adiponectin was 1.14 (1.05 to 1.24), while that for HMW adiponectin was 1.17 (1.08 to 1.27). Additional adjustment for putative mediators, including subclinical CVD, diabetes, lipids and inflammation, did not significantly affect these estimates. Conclusions: The present findings demonstrate that higher, not lower, levels of adiponectin are independently associated with increased risk of AF in older adults despite its documented cardiometabolic benefits. Additional work is necessary to determine if adiponectin is a marker of failed counter-regulatory pathways or whether this hormone is directly harmful in the setting of or as a result of advanced age.

AB - Background: Adiponectin has cardioprotective properties, suggesting that lower levels seen in obesity and diabetes could heighten risk of atrial fibrillation (AF). Among older adults, however, higher adiponectin has been linked to greater incidence of adverse outcomes associated with AF, although recent reports have shown this association to be U-shaped. We postulated that higher adiponectin would be linked to increased risk for AF in older adults in a U-shaped manner. Methods: We examined the associations of total and high-molecular-weight (HMW) adiponectin with incident AF among individuals free of prevalent cardiovascular disease (CVD) participating in a population-based cohort study of older adults (n=3190; age=74±5 years). Results: During median follow-up of 11.4 years, there were 886 incident AF events. Adjusted cubic splines showed a positive and linear association between adiponectin and incident AF. After adjusting for potential confounders, including amino-terminal pro-B-type natriuretic peptide 1-76, the HR (95% CI) for AF per SD increase in total adiponectin was 1.14 (1.05 to 1.24), while that for HMW adiponectin was 1.17 (1.08 to 1.27). Additional adjustment for putative mediators, including subclinical CVD, diabetes, lipids and inflammation, did not significantly affect these estimates. Conclusions: The present findings demonstrate that higher, not lower, levels of adiponectin are independently associated with increased risk of AF in older adults despite its documented cardiometabolic benefits. Additional work is necessary to determine if adiponectin is a marker of failed counter-regulatory pathways or whether this hormone is directly harmful in the setting of or as a result of advanced age.

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U2 - 10.1136/heartjnl-2014-307015

DO - 10.1136/heartjnl-2014-307015

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JO - Heart

JF - Heart

SN - 1355-6037

IS - 17

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