Plasma Adiponectin, Body Mass Index, and Mortality in Patients With Chronic Heart Failure
Abstract
Background— Recent studies have suggested that higher body mass index (BMI) is associated with improved prognosis in chronic heart failure (CHF). The adipocytokine adiponectin is inversely associated with BMI, and in healthy subjects, low adiponectin is a predictor of mortality. In a prospective study, we therefore evaluated the association between plasma adiponectin levels and mortality among patients with CHF. Methods and Results— In 195 CHF patients (age 69.3±10.2 years, BMI 27.3±5.2 kg/m 2 , left ventricular ejection fraction 30±8.9%, mean±SD), plasma adiponectin and N-terminal pro brain natriuretic peptide (NT-proBNP) were measured at baseline. Adiponectin was positively associated with NT-proBNP (β=0.47, P <0.001), and both biomarkers were negatively associated with BMI (β=−0.43, P <0.001 for adiponectin and β=−0.38, P <0.001 for NT-proBNP, respectively) During a median follow-up of 2.6 years, 46 (23.5%) of the patients died. After adjustment for clinical variables associated with CHF severity (age, systolic blood pressure, left ventricular ejection fraction <25%, duration of CHF, and creatinine clearance) and for NT-proBNP, the hazard ratio of mortality for values in the 2 upper tertiles relative to the lowest tertile of adiponectin was 3.23 ( P =0.032). BMI predicted mortality independently of clinical parameters of CHF severity (hazard ratio=0.63, P =0.012), but this association became insignificant after additional adjustment for NT-proBNP (hazard ratio=0.74, P =0.13). Conclusions— A high adiponectin level was a predictor of mortality, independent of risk markers of CHF severity, presumably because of its role as a marker for wasting. BMI was also associated with mortality, but a part of this relation may be mediated by adiponectin and NT-proBNP levels.
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A high circulating adiponectin level was a predictor of mortality in patients with congestive heart failure.
“In relation to the role of adiponectin in the obesity paradox, it was found that a high circulating adiponectin level was a predictor of mortality in patients with congestive heart failure (179).”
From Cardiac remodeling in obesity (2008) · cites this paper as [179]
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- Authors
- Kistorp, C., Faber, J., Galatius, S., Gustafsson, F., Frystyk, J., Flyvbjerg, A., & Hildebrandt, P.
- Affiliations
- Frederiksberg Hospital (DK)
- Venue
- Circulation
- Published
- 2005-09-20
- Volume
- 112
- Issue
- 12
- Pages
- 1756-1762
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2072526806
- Cited by
- 605
- References
- 39
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 8 · 2023: 22 · 2022: 21 · 2021: 13 · 2020: 20 · 2019: 17 · 2018: 12 · 2017: 25 · 2016: 32 · 2015: 18 · 2014: 23 · 2013: 48 · 2012: 48
- FWCI
- 29.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Keywords
- adiponectin, chronic heart failure, body mass index, mortality, NT-proBNP, adipokines, prognostic factors, wasting, obesity paradox, left ventricular ejection fraction
- MeSH terms
- Adult, Aged, Aged, 80 and over, Chronic Disease, Female, Heart Failure, Humans, Male, Middle Aged, Peptide Fragments, Regression Analysis, Biomarkers, Proportional Hazards Models, Survival Analysis, Natriuretic Peptide, Brain, Adiponectin
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