Resistin, Adiponectin, and Risk of Heart Failure The Framingham Offspring Study

Objectives We tested the association of the adipokines resistin and adiponectin with incident heart failure. Background Abnormal concentrations of adipokines may partially explain the association between obesity and heart failure. Methods We related circulating adipokine concentrations to the incidence of heart failure in 2,739 participants in the Framingham Offspring Study. Results During 6 years of follow-up, 58 participants developed new-onset heart failure. In proportional hazards models ( adjusting for age, sex, blood pressure, antihypertensive treatment, diabetes, smoking, total/high-density lipoprotein cholesterol ratio, prevalent coronary heart disease, valvular heart disease, left ventricular hypertrophy, and estimated glomerular filtration rate) using the lowest third of the resistin distribution as the referent, the hazard ratios for heart failure in the middle and top thirds were 2.89 (95% confidence interval [CI]: 1.05 to 7.92) and 4.01 ( 95% CI: 1.52 to 10.57), respectively ( p = 0.004 for trend). Additional adjustment for body mass index, insulin resistance ( measured with the homeostasis model), C-reactive protein, and B-type natriuretic peptide did not substantively weaken this association ( multivariable hazard ratios [HRs]: 2.62 and 3.74, p = 0.007). In the maximally adjusted model, each SD increment in resistin (7.45 ng/ml) was associated with a 26% increase in heart failure risk ( 95% CI: 1% to 60%). Concentrations of adiponectin were not associated with heart failure ( multivariable HRs: 0.87 and 0.97, p = 0.9). Conclusions Increased circulating concentrations of resistin were associated with incident heart failure, even after accounting for prevalent coronary heart disease, obesity, and measures of insulin resistance and inflammation. The findings suggest a role for resistin in human disease and a novel pathway to heart failure. (J Am Coll Cardiol 2009; 53: 754-62) (C) 2009 by the American College of Cardiology Foundation