Adipokine-mediated metabolic responses across BMI in acute myocardial infarction

Adipose tissue secretes adipokines, bioactive proteins that regulate inflammation and cardiometabolic processes. During acute myocardial infarction (AMI), adipokine profiles may vary according to body mass index (BMI), yet this association remains underexplored.

To compare circulating adiponectin, fibroblast growth factor 21 (FGF21), growth differentiation factor 15 (GDF15), and interleukin-6 (IL-6) between non-obese and obese patients with AMI.

In this cross-sectional study, 105 patients with AMI were stratified as non-obese (BMI < 25 kg/m², n = 62) or obese (BMI ≥ 25 kg/m², n = 43). Serum adiponectin, GDF15, and IL-6 were measured by Luminex, and FGF21 was measured by ELISA. Clinical variables and lipid indices were compared between BMI groups, and correlation analyses were performed.

Although myocardial injury levels were comparable between the two groups, non-obese patients had significantly higher serum levels of adiponectin, FGF21, GDF15, and IL-6 than obese patients (all p < 0.05). In all patients, adiponectin was negatively correlated with total cholesterol, LDL-c, and triglycerides, and positively correlated with HDL-c; however, these associations were not consistently observed within BMI subgroups after stratification and FDR correction. GDF15 and IL-6 also showed inverse correlations with selected lipid parameters in all patients.

Non-obese AMI patients exhibited higher levels of adiponectin, FGF21, GDF15, and IL-6 compared to obese AMI patients. These adipokine profiles were associated with lipid parameters, notably showing inverse correlations between adiponectin and GDF15 with total cholesterol and LDL-c. These findings highlight the association between adiposity and early metabolic responses in AMI across BMI categories.