Adipokines and Cardiometabolic Risk in South Asian Americans: Findings from the MASALA Study

Background: South Asian Americans face a disproportionately high burden of atherosclerotic cardiovascular disease. Adipokines, specifically adiponectin, leptin, and resistin, may contribute to this risk; however, their associations with cardiometabolic risk factors in this population remain understudied. Objective: To evaluate associations between adipokine levels and adipokine indices with cardiometabolic outcomes among South Asian Americans in the MASALA (Mediators of Atherosclerosis in South Asians Living in America) cohort. Methods: We conducted a cross-sectional analysis of 891 South Asian American adults. Associations between 1-SD differences in adiponectin, leptin, resistin, adiponectin/leptin ratio, and adiponectin-resistin index and prevalent hypertension, dyslipidemia, and diabetes were assessed via multivariable regression adjusting for demographics, lifestyle, adiposity, and inflammatory markers. Gender interactions were assessed with gender-stratified results reported when significant. Results: Participants (mean age 55.3 ± 9.4 years; 46% women) had a high prevalence of dyslipidemia (73.5%), hypertension (40.3%), and diabetes (25.3%). Higher adiponectin was associated with lower odds of dyslipidemia overall (OR 0.65, 95% CI: 0.54-0.78) and diabetes in women (OR 0.54, 95% CI: 0.37-0.76). Resistin was inversely associated with diabetes in men (OR 0.63, 95% CI: 0.42-0.89) while adiponectin-resistin index was associated with dyslipidemia overall (OR 1.36, 95% CI: 1.15-1.62) and diabetes in women (OR 1.83, 95% CI: 1.27-2.77). Leptin and adiponectin/leptin ratio showed no significant associations. Conclusion: Adiponectin and adiponectin-resistin index were inversely and positively, respectively, associated with dyslipidemia overall and diabetes in women. Resistin demonstrated an inverse association with diabetes in men. These descriptive findings highlight adipokine profiles and their associations in South Asian Americans.