title: Decreased serum lipoprotein levels as a guide for clinical severity in patients with idiopathic dilated cardiomyopathy.
abstract: Hyperlipidemia is a cardiovascular risk factor. In patients with idiopathic dilated cardiomyopathy (IDC), prognostic roles of endogenous lipoproteins are not fully clarified. It has been known that there is a direct relationship between the levels of cytokines (tumor necrosis factor-alpha [TNF-alpha] and interleukin-6 [IL-6]) and deteriorating functional classes of heart failure and mortality. The present study compared the levels of circulating TNF-alpha, IL-6, lipoproteins, and apolipoproteins in patients with stable IDC (n = 28) with those of patients with unstable IDC (n = 26) and controls (n = 24). Mean serum total cholesterol (TC) was significantly lower in stable IDC patients than controls (p < 0.05). In unstable IDC patients, mean serum TC was also lower than controls but not statistically significant. The IDC patients had significantly higher concentrations of IL-6 and TNF-alpha than the controls (p < 0.01). Serum IL-6 and Apo AI levels were significantly different between stable and unstable IDC patients (p = 0.021 and p = 0.012, respectively). Increased levels of IL-6 were associated with decreased levels of TC (r = -0.266, p = 0.019), LDL-C (r = -0.376, p = 0.001) and apolipoprotein AI (apo AI) (r = -0.495, p < 0.001) in all IDC patients. TNF-alpha was also inversely related to apo AI (r = -0.455, p < 0.001) and LDL-C (r = -0.364, p = 0.001) in all patients. Thus, elevated serum levels of cytokines in patients with IDC are associated with decreased lipoprotein concentrations, which may indicate impaired prognosis.
authors.affiliation: Department of Biochemistry, Inonu University Medical Faculty, Malatya, Turkey. nurzensezgin@hotmail.com
authors.forename: Nurzen
authors.initials: N
authors.lastname: Sezgin
authors.forename: Alpay T
authors.initials: AT
authors.lastname: Sezgin
authors.forename: Hakan
authors.initials: H
authors.lastname: Gullu
authors.forename: Aysun
authors.initials: A
authors.lastname: Karabulut
authors.forename: Irfan
authors.initials: I
authors.lastname: Barutcu
authors.forename: Ergun
authors.initials: E
authors.lastname: Topal
authors.forename: Defne
authors.initials: D
authors.lastname: Yalcintas
authors.forename: Ismail
authors.initials: I
authors.lastname: Temel
mesh_terms: D000328:Adult; D000368:Aged; D016632:Apolipoprotein A-I / Q000378:metabolism; D001053:Apolipoproteins / Q000378:metabolism; D002311:Cardiomyopathy, Dilated / Q000097:blood* / Q000175:diagnosis; D002784:Cholesterol / Q000378:metabolism; D008076:Cholesterol, HDL / Q000378:metabolism; D008078:Cholesterol, LDL / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism; D004452:Echocardiography; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism; D008074:Lipoproteins / Q000097:blood* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D016632:Apolipoprotein A-I; D001053:Apolipoproteins; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D016207:Cytokines; D015850:Interleukin-6; D008074:Lipoproteins; D014409:Tumor Necrosis Factor-alpha; D002784:Cholesterol; D005947:Glucose