Aims: We aimed to explore whether there was a joint effect of serum lipocalcin-2 (LCN2) levels and fat distribution or interaction on the development of cardiovascular disease (CVD) in a middle-aged and elderly, community-based cohort.

Methods: This prospective study included 1,349 participants (583 men and 766 postmenopausal women) aged 50-80 years, without evident CVD from Shanghai communities in 2013-2014. All participants underwent complete risk factor survey and body composition measurement at baseline. The follow-up assessment was conducted in 2021-2022 for cardiovascular events via phone calls and electronic medical records. Magnetic resonance imaging was used to assess fat distribution including subcutaneous fat area (SFA) and visceral fat area (VFA). SFA ≥ 75th percentile was classified as high, and VFA ≥ 80 cm2 was defined as high.

Results: During a mean follow-up of 7.6 years, 140 (10.4%) cases of cardiovascular events occurred, with 56 cases of ischemic heart diseases and 84 cases of cerebrovascular events. In fully adjusted Cox proportional hazards models, increasing baseline serum LCN2 levels were associated with a higher risk of cardiovascular events in women (HR for per 10 ng/mL increase: 1.11, 95%CI 1.02-1.20), but disappeared in men (HR for per 10 ng/mL increase: 1.00, 95%CI 0.93-1.08). Fat distribution modified the association between serum LCN2 levels and cardiovascular events in women, strengthening the association at low VFA levels (Pinteraction = 0.024), regardless of SFA levels (Pinteraction = 0.190).

Conclusions: Increasing LCN2 levels were independently and positively associated with the risk of cardiovascular events in women, which could be interacted by fat distribution at baseline.

Disclosure

T.Hu: None. Y.Xu: None. Y.Shen: None. Y.Wang: None. X.Ma: None. Y.Bao: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.