Key result
Higher adiponectin in older adults linked to ~91% greater incident heart failure risk.
Why the study?
Adiponectin is associated with adverse outcomes in older age, but whether this reflects overlapping pathophysiological pathways with NT-proBNP is unclear.
Do elevated adiponectin and NT-proBNP levels predict incident cardiovascular events in older adults without baseline CVD?
Cohort (n=4,729)
Yes
Do elevated adiponectin and NT-proBNP levels predict incident cardiovascular events in older adults without baseline CVD?
Elevated adiponectin and NT-proBNP in older adults without baseline CVD are associated with increased risk for HF and CVD death beyond traditional risk factors.
Answers are grounded in this paper and cite their sources.
May flag higher HF and CVD death risk in older adults without CVD; leaves open whether adiponectin refines prediction beyond NT-proBNP.
BACKGROUND: Adiponectin, an atheroprotective adipokine, is associated with adverse outcomes in older age. It is unclear whether this is due to overlapping pathophysiological pathways with N-terminal pro-B-type natriuretic peptide (NT-proBNP). OBJECTIVES: The authors investigated adiponectin's associations with cardiovascular disease (CVD) risk in older adults. METHODS: Among Atherosclerosis Risk in Communities prospective cohort study participants without baseline CVD at visit 5 (n = 4,729, mean age 75), adiponectin and adiponectin/NT-proBNP category associations with incident CVD events (heart failure [HF], atherosclerotic cardiovascular disease, and death during median follow-up of 5.5 years) and echocardiographic parameters were assessed. Metabolomic signatures of adiponectin/NT-proBNP categories were explored. RESULTS: Higher adiponectin was associated with older age, female sex, and less obesity, diabetes, and hypertension but increased risk for incident HF (HR: 1.91 [95% CI: 1.49-2.44], per natural-log unit increase) and CVD death (HR: 1.67 [95% CI: 1.19-2.32]). Interaction of NT-proBNP with adiponectin was significant for HF (P-interaction = 0.03). There was no significant association between adiponectin and heart failure with preserved ejection fraction after adjusting for NT-proBNP. Elevations of both biomarkers (A+ [upper tertile]/N+ [≥125 pg/mL]) had higher risk (vs A+/N-; HF: HR 5.41 [95% CI: 2.72-10.78]; CVD death: HR 3.50 [95% CI: 1.48-8.24]). Compared with A+/N-, A-/N+ had increased risk for HF (HR 2.84 [95% CI: 1.41-5.72]) while A-/N- had no increased event risk. A+/N+'s metabolomic signature (88% similar to NT-proBNP's) showed acylcarnitine species consistent with incomplete beta-oxidation; top-associated metabolites were significantly associated with HF and CVD death. CONCLUSIONS: Elevated adiponectin and NT-proBNP in older adults are associated with increased risk for HF and CVD death beyond traditional risk factors.
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Abushamat et al. (2025) conducted a cohort in Older adults without baseline cardiovascular disease (n=4,729). Adiponectin vs. Lower adiponectin levels was evaluated on Incident heart failure hospitalization (per natural-log unit increase in adiponectin) (HR 1.91, 95% CI 1.49-2.44, p=<0.001). Higher adiponectin levels in older adults were associated with an increased risk for incident heart failure (HR 1.91) and cardiovascular death (HR 1.67) beyond traditional risk factors.
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