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Arrhythmias and sudden death
Original article
The associations of leptin, adiponectin and resistin with incident atrial fibrillation in women
  1. Simon Ermakov1,
  2. Farnaz Azarbal1,
  3. Marcia L Stefanick1,
  4. Michael J LaMonte2,
  5. Wenjun Li3,
  6. Katie M Tharp4,
  7. Lisa W Martin5,
  8. Rami Nassir6,
  9. Elena Salmoirago-Blotcher7,
  10. Christine M Albert8,
  11. JoAnn E Manson9,
  12. Themistocles L Assimes1,
  13. Mark A Hlatky1,
  14. Joseph C Larson10,
  15. Marco V Perez1
  1. 1Division of Cardiovascular Medicine, Department of Medicine, Stanford, University School of Medicine, Stanford, California, USA
  2. 2Department of Social and Prevention Medicine, School of Public Health and Health Professions, University of Buffalo, Buffalo, New York, USA
  3. 3Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA
  4. 4Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA
  5. 5GW Medical Faculty Associates Cardiology Division, School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia, USA
  6. 6Department of Biochemistry and Molecular Medicine, University of California Davis, Sacramento, California, USA
  7. 7Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA
  8. 8Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
  9. 9Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
  10. 10Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA
  1. Correspondence to Dr Simon Ermakov, Division of Cardiovascular Medicine, Department of Medicine, Stanford, University School of Medicine, 300 Pasteur Drive MC 5233 H2146, Stanford CA 94305, USA; Sermakov{at}Stanford.edu

Abstract

Objectives Higher body mass index (BMI) is an important risk factor for atrial fibrillation (AF). The adipokines leptin, adiponectin and resistin are correlates of BMI, but their association with incident AF is not well known. We explored this relationship in a large cohort of postmenopausal women.

Methods We studied an ethnically diverse cohort of community-dwelling postmenopausal women aged 50–79 who were nationally recruited at 40 clinical centres as part of the Women's Health Initiative investigation. Participants underwent measurements of baseline serum leptin, adiponectin and resistin levels and were followed for incident AF. Adipokine levels were log transformed and normalised using inverse probability weighting. Cox proportional hazard regression models were used to estimate associations with adjustment for known AF risk factors.

Results Of the 4937 participants included, 892 developed AF over a follow-up of 11.1 years. Those with AF had higher mean leptin (14.9 pg/mL vs 13.9 pg/mL), adiponectin (26.3 ug/mL vs 24.5 ug/mL) and resistin (12.9 ng/mL vs 12.1 ng/mL) levels. After multivariable adjustment, neither log leptin nor log adiponectin levels were significantly associated with incident AF. However, log resistin levels remained significantly associated with incident AF (HR=1.57 per 1 log (ng/mL) increase, p=0.006). Additional adjustment for inflammatory cytokines only partially attenuated the association between resistin and incident AF (HR=1.43, p=0.06 adjusting for C-reactive protein (CRP); HR=1.39, p=0.08 adjusting for IL-6). Adjusting for resistin partially attenuated the association between BMI and incident AF (HR=1.14 per 5 kg/m2, p=0.006 without resistin; HR=1.12, p=0.02 with resistin).

Conclusions In women, elevated levels of serum resistin are significantly associated with higher rates of incident AF and partially mediate the association between BMI and AF. In the same population, leptin and adiponectin levels are not significantly associated with AF.

https://doi.org/10.1136/heartjnl-2015-308927

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