Introduction: Brain natriuretic peptide (BNP) is used to evaluate the presence and the severity of acute congestive heart failure (ACHF). Adipokines such as adiponectin and leptin have been associated with measures of left ventricular structure and function, and also with ACHF. As African Americans experience disproportionate prevalence and magnitude of cardiovascular risk factors, the objective of our study was to assess the relationship between these adipokines and BNP among African Americans.
Methods: A total of 4,127 (63% female) African American participants from the Jackson Heart Study were recruited. Participants with end stage renal disease or with missing data were excluded from analysis. Multivariable adjusted linear models were used to determine the association between adipokines and BNP. Biomarkers were transformed by their natural logarithm to satisfy the normality assumption. Model 1 was adjusted for demographic factors, body mass index, glomerular filtration rate, diabetes mellitus and hypertension. Model 2 was additionally adjusted for echocardiographic measures. Model 3 was adjusted for those in Model 1 as well as aldosterone, renin and adiponectin or leptin. Sex stratified analyses were conducted for linear models. BNP was dichotomized by the threshold of 100 pg/mL and both adipokines were dichotomized by their 90th percentile. Multivariable adjusted logistic regression was used to calculate the odds ratios for associations of adipokines and BNP.
Results: Mean (SD) BNP levels were 18.19 (53.00) pg/mL in men and 19.14 (62.23) (t-test p=0.61). Mean (SD) adiponectin levels were 4,091.30 (3,406.40) ng/mL and 6,043.50 (3,406.50) ng/mL in men and women, respectively (t-test p<0.01). Mean (SD) levels for leptin were 11.39 ng/mL (10.33) and 37.79 ng/mL (23.81)] in men and women, respectively (t-test p <0.01). A direct association was observed between adiponectin and BNP (Model 1 β = 0.43 Model 2 β = 0.41, and Model 3 β = 0.35; all p <0.001). For the relationship of leptin and BNP, an inverse association was observed (Model 1 β = -0.17, p < 0.001; Model 2 β = -0.20, p < 0.001; Model 3 β = - 0.07, p=0.047). Stratification by sex yielded similar results in Models 1 and 2, but significance was lost between leptin and BNP in Model 3. In logistic models, those in the highest decile had increased odds of elevated BNP in Model 1 [OR=2.29, 95% CI (1.33-3.94)] and Model 2 [OR=3.65, 95% CI (1.59-3.75)]. Statistical significance was lost after further adjustment. No associations were found significant in logistic models of leptin and BNP.
Conclusions: Among African American participants, there was an inverse association between leptin and BNP and a direct association between adiponectin and BNP, indicative of a putatively complex compensatory association between these biomarkers.