Obesity, Adipokines, and Abdominal Aortic Aneurysm

BACKGROUND: Obesity is associated with occlusive artery disease but is not considered a risk factor for abdominal aortic aneurysm (AAA). We investigated the association between anthropometric measures of obesity, serum adipokines, and AAA. METHODS AND RESULTS: As part of a population study, we screened 12,203 men 65 to 83 years of age for AAA using ultrasound; 875 had an AAA (> or = 30 mm). Cardiovascular risk factors and waist and hip circumference were recorded. Serum adipokines were measured in 952 men, 318 of whom had an AAA. Waist circumference (odds ratio OR, 1.14; 95% confidence interval CI, 1.06 to 1.22) and waist-to-hip ratio (OR, 1.22; 95% CI, 1.09 to 1.37) were independently associated with AAA after adjustment for other known risk factors. The association was stronger for AAA > or = 40 mm (waist-to-hip ratio: OR, 1.53; 95% CI, 1.26 to 1.85). Serum resistin concentration was strongly independently associated with AAA (OR, 1.53; 95% CI, 1.32 to 1.76) and aortic diameter (beta=0.19, P or = 30 mm (OR, 1.26; 95% CI, 1.07 to 1.50) but not AAA > or = 40 mm (OR, 1.03; 95% CI, 0.77 to 1.39). Serum leptin was not associated with AAA. CONCLUSIONS: Measures of obesity are independently associated with AAA. Serum resistin concentrations were more strongly associated with aortic diameter than adipokines that are more intimately associated with adiposity. Further studies are required to investigate the mechanisms linking resistin and AAA.