Adiponectin is a polypeptide hormone secreted by adipose tissue that has been implicated as an anti-inflammatory mitigator of vascular disease but also as a marker of increased cardiovascular (CV) risk. It is down regulated in obesity, which has been associated with pulmonary hypertension (PH). We sought to examine the relationship between adiponectin levels and PH in participants in the Jackson Heart Study (JHS), a prospective cohort study of CV disease in African-Americans.
Cross-sectional analysis of data from the JHS on plasma adiponectin levels (exposure) and PH (pulmonary artery systolic pressure>40mmHg on echocardiogram) (outcome) on participants with complete information on exposure, outcome, and pre-specified covariates. The study population was divided into quartiles based on adiponectin level: Q1≤2685.15ng/ml; Q2:>2685.15-≤4247.40ng/ml; Q3:>4247.40-≤6790.23ng/ml; Q4:>6790.23ng/ml. Baseline characteristics were compared across quartiles. Crude and adjusted prevalence ratios for PH were calculated by adiponectin quartile.
In the overall study population (n=2,736), 50.9% were obese and 4.9% had PH. Participants in the highest quartile of adiponectin were older (Q4:31.6%≥65years, vs. Q1:16.3%≥65years) but had less obesity (Q4:40.4% vs. Q1:58.2%) and diabetes (Q4:15.2% vs. Q1:22.0%). In adiponectin Q4, 7.9% had PH vs. 2.9% in Q1. Both crude and adjusted prevalence ratios for PH were significantly elevated in the highest quartile of adiponectin compared to the lowest quartile, while the prevalence ratios in Q2 and Q3 were not significantly elevated (Table 1).
Despite less obesity and diabetes, African-Americans with elevated adiponectin levels (upper quartile) had a higher prevalence of pulmonary hypertension.