Association of low plasma adiponectin with early diastolic dysfunction

Abstract

Diastolic dysfunction (DD) with preserved left ventricular (LV) ejection fraction (EF) has been linked to obesity. Adiponectin is a cytokine related to obesity and obesity-linked cardiovascular complications. The authors aimed to determine the independent association of DD with adiponectin. Fifty patients with impaired relaxation DD and a normal EF and age-matched normal controls were recruited. Plasma levels of total and high molecular weight (HMW) adiponectin were measured. Mid and low molecular weight (MMW+LMW) fractions of adiponectin were calculated by subtracting HMW fraction from total adiponectin. The DD group had significantly lower total (median, 4.4 vs 12.7 μg/mL; P=.001), HMW fraction (median, 1.3 vs 3.4 μg/mL; P=.02), and MMW+LMW fraction of adiponectin (median, 3.8 vs 7.2 μg/mL; P=.01). Body mass index (BMI) negatively correlated with total (r:-0.46, P=.003), HMW (r:-0.32, P=.038), and MMW+LMW (r:-0.40, P=.006) fractions of adiponectin. DD had an independent association with both BMI (P<.05) and total adiponectin (P<.001) in linear regression model using sex, BMI, blood pressure, and total adiponectin as covariates. DD was associated with BMI (P=.02), HMW fraction (P=.03), and MMW+LMW fraction (P=.004) in similar linear regression analyses. Adiponectin deficiency may be one explanation for the adiposity-related cardiac oxidation known to be involved in the pathogenesis of DD.

FIGURE 1

Comparison of (top) total, (center) high molecular weight (HMW), and (bottom) mid molecular weight (MMW) + low molecular weight (LMW) adiponectin levels between patients with and without diastolic dysfunction. DD indicates diastolic dysfunction. Horizontal bars show median levels, boxes show interquartile range, and vertical error bars show 95% confidence intervals for the median; P value derived from nonparametric comparison.

FIGURE 2

Correlation of body mass index with (top) total, (center) high molecular weight (HMW), and (bottom) mid molecular weight (MMW) + low molecular weight (LMW) adiponectin levels. DD indicates diastolic dysfunction. Dotted lines show 95% confidence intervals for individual cases.