title: Relationship between adiponectin and left atrium size in uncomplicated obese patients: adiponectin, a link between fat and heart.
abstract: BACKGROUND
  It is well known that obesity is a risk factor for severe cardiovascular complications, such as coronary heart disease, heart failure, stroke, venous thromboembolic disease, and atrial fibrillation. Left ventricle (LV) and left atrium (LA) enlargement is a characteristic feature of these patients with the consequent cardiovascular risk. Factors other than hemodynamic may influence LA remodeling. The aim of the study is to evaluate the relationship between adiponectin and LA size in uncomplicated obese patients.
  
  
  METHODS
  Seventy-four asymptomatic obese patients and an age- and sex-matched control group (N = 70) were recruited. A detailed clinical, echocardiographic, and analytical study was performed. Insulin resistance was assessed using the homeostasis model assessment for insulin resistance (HOMA-IR) method. Insulin sensitivity was assessed measuring serum total adiponectin concentrations.
  
  
  RESULTS
  Adiponectin levels were lower in the obese group (P < 0.001) and particularly so in those obese participants with enlarged LA (32%; P < 0.0005). LA sizes were higher in the obese group (P < 0.0005). Adiponectin displayed significant correlations with body mass index, glucose, insulin, high-density lipoprotein cholesterol, and triglyceride concentrations as well as HOMA-IR (P < 0.001 for all). Adiponectin displayed significant correlations with LV mass and LA size, diastolic and systolic cardiac volumes and diameters, and cardiac output (P < 0.001 for all). Adiponectin correlations with LA size (r = -0.429; P < 0.001) persisted after adjustment for HOMA-IR, age, sex, and LV mass.
  
  
  CONCLUSIONS
  A novel inverse relationship between adiponectin and LA size independent of age, sex, insulin resistance, and LV mass appears in our series. Adiponectin could be a link between adipose tissue and the heart, having an influence on cardiac remodeling.
authors.affiliation: Instituto de Cardiología y Medicina Avanzada, Centro Médico Teknon, Barcelona 08017, Spain. JYbarraM@santpau.cat
authors.forename: Juan
authors.initials: J
authors.lastname: Ybarra
authors.forename: Eugenia
authors.initials: E
authors.lastname: Resmini
authors.forename: Francesc
authors.initials: F
authors.lastname: Planas
authors.forename: Francesc
authors.initials: F
authors.lastname: Navarro-López
authors.forename: Susan
authors.initials: S
authors.lastname: Webb
authors.forename: Jose Maria
authors.initials: JM
authors.lastname: Pou
authors.forename: Alicia
authors.initials: A
authors.lastname: Santos
authors.forename: Carlos
authors.initials: C
authors.lastname: Ballesta-López
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D015150:Echocardiography, Doppler; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000150:complications / Q000473:pathology*; D013318:Stroke Volume; D055815:Young Adult
chemical_list: D052242:Adiponectin