Author/Editor		Szabó, Tibor; Lainščak, Mitja
Title		Plasma adiponectin in heart failure with and without cachexia
Type		članek
Publication year		2013
Volume		str. 1-7
ISSN		0939-4753 - Nutrition, metabolism, and cardiovascular diseases : NMCD
Language		eng
Abstract		Background and aims: Adiponectin (ADPN) as an adipose tissue hormone contributes to regulation of energy metabolism and body composition and is associated with cardiovascular risk profile parameters. Cardiac cachexia may develop as a result of severe catabolic derangement in chronic heart failure (CHF). We aimed to determinate an abnormal ADPN regulation as a link between catabolic signalling, symptomatic deterioration and poor prognosis. Methods and results: We measured plasma ADPN in 111 CHF patients (age 65 +- 11,90% male, left ventricular ejection fraction (LVEF) 36 +- 11%, peak oxygen consumption (peakVO2) 18.1 +- 5.7 l/kg*min, body mass index (BMI) 27 +- 4 kg/m2, all mean +- standard deviation) and 36 healthy controls of similar age and BMI. Body composition was assessed by dual energy X-ray absorptiometry, insulin sensitivity was evaluated by homoeostasis model assessment, exercise capacity by spiroergometry. Plasma ADPN did not differ between CHF vs. controls (13.5 +- 11.0 vs. 10.5 +- 5.3 mg/l, p > 0.4), but increased stepwise with NZHA functional class (I/II/III: 5.7 +- 1.4/10.7 +- 8.3/19.2 +- 14.0 mg/l, ANOVA p < 0.01). Furthermore, ADPN correlated with VO2 at anaerobic threshold (r = -0.34, p < 0.05). ADPN was highest in cachectic patients (cCHF, 16%) vs. non-cachectic (ncCHF) (18.7 +- 15.0 vs. 12.5 +- 9.9 mg/l; p < 0.05). ADPN indicated mortality risk independently of established prognosticators (HR: 1.04 95% CI: 1.02-1.07; p < 0.0001). ADPN above the mean (13.5 mg/l) was associated with a 3.4 times higher mortality risk in CHF vs. patients with ADPN levels below the mean. Conclusion: Circulating ADPN is abnormally regulated in CHF. ADPN may be involved in impaired metabolic signalling linking disease progression, tissue wasting, and poor outcome in CHF.
Keywords		chronic heart failure cachexia metabolism adiponectin