Abstract P323: Three Year Changes in Adipokine Levels and Metabolic Risk Status: The Atherosclerosis Risk in Communities (ARIC) Study

Introduction: Adipokine levels are strongly linked to diabetes and metabolic syndrome, with higher adiponectin having protective associations and higher leptin having harmful associations. Little is known about how past changes in adipokine levels relate to current metabolic risk. Methods: Among ARIC Visit 3 (1993-1995) participants, we examined the association of past changes in adiponectin and leptin levels over the 3-year period from ARIC Visit 2 (1990-1992) to Visit 3 with prevalent diabetes and metabolic syndrome at Visit 3. Adipokines were measured using aptamer technology (correlated 0.9x with immunoassay) and analyzed categorically as >50% increase, >50% decrease and <50% change (stable). Multivariable logistic regression was performed to assess associations with stratification by obesity (BMI ≥ 30 kg/m 2 ) status. Results: Among 9,287 Visit 3 participants, the mean age was 61 years with 56% female and 19% Black adults. Relative to stable levels, a >50% increase in adiponectin over the past 3 years was associated with higher odds of prevalent diabetes (OR 1.62; 95% CI: 1.29-2.03) and metabolic syndrome (OR 1.45; 95% CI: 1.22-1.72). Past increases in leptin were associated with lower odds of diabetes (OR 0.64; 95% CI: 0.53-0.77) and metabolic syndrome (OR 0.70; 95% CI: 0.62-0.77) (Table). Compared to stable levels, >50% decrease in adiponectin over time was associated with lower likelihood of diabetes and metabolic syndrome. Decreasing leptin had nonsignificant associations. Patterns were largely consistent in obesity stratified analyses, with the principal difference being that adiponectin increase was only associated with increased metabolic risk in those without obesity. Conclusion: Recent changes in adipokine levels are linked to current metabolic status. A past increase in adiponectin has direct associations, while increasing leptin has inverse associations. The underlying mechanisms and implications for metabolic risk in older age should be further studied.