Greater Circulating Adipokines May Play a Role in Early ILD Pathogenesis

Higher adiponectin levels are associated with lower high attenuation areas (HAA), a computed tomography (CT)-based measure of subclinical interstitial lung disease (ILD), in community-dwelling adults with high body mass index (BMI), according to study results published in CHEST.

In addition, the findings suggest that adiposity and higher levels of circulating proinflammatory adipokines may play a role in lung inflammation and scarring during the early pathogenesis of ILD.

Community-dwelling adults from the Multi-Ethnic Study of Atherosclerosis cohort (n=1968) cohort aged 45 to 84 years who had adiponectin, leptin, and resistin measured during follow-up visits were included in the study. Researchers assessed the associations between HAA from CT scans with levels of adiponectin, leptin, and resistin adipokines. Additionally, assessments were made to identify associations between these adipokines and interstitial lung abnormalities (ILA) from CT scans (n=872) and forced vital capacity (FVC) from spirometry (n=1446).

In participants with BMI ≥25 kg/m², higher levels of adiponectin were associated with lower HAA (P =.07). The H was 21.9 units lower for every 1-standard deviation (SD) increment of log-transformed adiponectin in this high BMI group (95% CI, -36.9 to -6.9). Relative to ever smokers, leptin held a stronger association with ILA in individuals who never smoked (P =.004). The percent predicted FVC was 3.8% lower for every 1-SD increment of log-transformed leptin (95% CI, -5.0 to -2.5). 

The association between serum leptin and resistin with percent predicted FVC was strongest in men vs women (all P ≤.007). In the fully adjusted model, higher levels of serum resistin correlated with greater HAA. There was an increase in H of 14.8 (95% CI, 3.4-26.3) for every 1-SD increment of log-transformed resistin.

A limitation of the study included the smaller sample size for the ILA analysis compared with the sample sizes for HAA and FVC.

The researchers wrote that additional “mechanistic studies will be informative and help identify those individuals who may be at higher risk of developing ILD.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Kim JS, Anderson MR, Podolanczuk AJ, et al. Associations of serum adipokines with subclinical interstitial lung disease among community-dwelling adults: the MESA study [published online October 31, 2019]. CHEST. doi:10.1016/j.chest.2019.10.011