Serum Resistin Concentrations and Incident Heart Failure in Older Adults Öffentlichkeit
Wang, Zhaochuan (2013)
Published
Abstract
Abstract
Serum Resistin Concentrations and Incident Heart Failure in Older Adults
By Zhaochuan Wang
Objectives: Resistin is a polypeptide found in adipocytes that promotes insulin resistance and may be a novel risk factor for heart failure. We investigated the association between baseline serum resistin concentrations and incident heart failure (HF) during the next 5 years for adults aged 70-79 years.
Methods: We used data from the Health, Aging, and Body Composition (Health ABC) Study, a prospective, NIH-funded cohort study, which enrolled 3075 participants from Pittsburg, PA, and Memphis, TN. Kaplan-Meier survival curves were plotted for incident HF during the 5-year follow up by resistin quartiles, overall and in subgroups by race and gender. The Cochran-Armitage trend test was used to compare incident HF across quartiles of baseline serum resistin concentrations. Cox proportional hazards model was used to assess whether baseline serum resistin concentration was associated with incident HF over 5 years of follow up. Assessment of interaction and confounding was performed.
Results: Median follow-up time was 949 days. Incident HF curves were significantly different among resistin quartile groups (log-rank test p-value < 0.0001). The lowest quartile of serum resistin had the highest probability of HF-free survival, followed by 2nd, 3rd quartiles, and lastly the 4th quartile. Serum resistin concentration was associated with incident HF during the follow-up period [raw HR per 10 ng/ml increase = 1.21 (95% CI: 1.16-1.27), p=0.005;]. The multivariable adjusted effect of resistin HR per 10 ng/ml increase in the overall population is 1.13 (95% CI: 1.11-1.15, p=0.14). This association was modified by baseline physical activity status (p-value for interaction= 0.0438). The hazard of incident HF was 1.21 (95% CI: 1.19-1.23, p=0.006) and 1.22 (95% CI: 1.21-1.24, p=0.004) per 10 ng/ml increase in serum resistin level for participants with physical activity and physical inactivity respectively. This effect of resistin on incident HF was also confounded by sitting systolic blood pressure, heart rate, trunk fat, total fat percentage, and baseline serum albumin concentration.
Conclusions: Serum resistin concentration is associated with incident HF over 5 years in older adults, and this association was modified by physical activity and confounded by sitting systolic blood pressure, heart rate, trunk fat, total fat percentage, and baseline serum albumin concentration.
Table of Contents
Chapter 1. 1
Literature Review.. 1
Heart Failure. 1
Risk Factors for Heart Failure. 2
Resistin. 4
Relationship between Resistin and Heart Failure. 5
Chapter 2. 6
Manuscript 6
Abstract 6
1 INTRODUCTION. 7
1.1 Background. 7
1.2 Objectives. 7
2 METHODOLOGY. 8
2.1 Study population and data collection. 8
2.2 Time to Heart Failure Event 9
2.3 Measurement of Exposure. 9
2.4 Covariate Definitions. 9
2.5 Statistical Analyses. 10
3 RESULTS. 14
3.1 Cohort demographics 14
3.2 Kaplan-Meier estimate curves for survival until the first
incident HF 16
3.3 Association of resistin with incident HF during 5 years of
follow up. 16
3.4 Evaluation of PH assumption. 17
4 DISCUSSION. 18
REFERENCES. 21
TABLES AND FIGURES. 1
Table 1 Comparison of sociodemographic, clinical, and program
characteristics (discrete variables) by incident HF over 5 years of
follow up. 1
Table 2 Comparison of sociodemographic, clinical, and program
characteristics (continuous variables) by incident HF over 5 years
of follow up. 1
Table 3 Bivariate analysis for quartiles of serum resistin
concentration. 28
Table 4 Multivariate Cox PH model to test association between
resistin and incident HF over 5 years of follow up for patient with
high physical activity. 29
Table 5 Multivariate Cox PH model to test association between
resistin and incident HF over 5 years of follow up for patient with
low physical activity. 30
Table 6 Goodness of Fit Test - Pearson correlation test between the
Schoenfeld residuals and ranked failure time 31
Figure 1 Distribution of baseline serum resistin concentration.
32
Figure 2 Overall incident HF by serum resistin quartiles. 33
Figure 3 Incident HF by serum resistin quartiles in subgroups.
34
Appendix A SAS Output for confounder assessment 35
Appendix B SAS Output for interaction assessment 171
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