Adiponectin in outpatients with coronary artery disease: independent predictors and relationship with heart failure.
OBJECTIVE
Chronic heart failure (HF) is characterised by a neurohormonal dysfunction associated with chronic inflammation. A role of metabolic derangement in the pathophysiology of HF has been recently reported. Adiponectin, an adipose-tissue-derived cytokine, seems to play an important role in cardiac dysfunction. We investigated the variation of circulating adiponectin in patients with coronary artery disease (CAD), with or without HF, in order to identify its independent predictors.


RESULTS
A total of 107 outpatients with CAD were enrolled in the study and divided into three groups: CAD without left ventricular systolic dysfunction (group 1); CAD with left ventricular dysfunction without HF symptoms (group 2) and CAD with overt HF (group 3). Plasma adiponectin was determined by enzyme-linked immunosorbent assay. Adiponectin concentrations increased progressively from group 1 (7.6 ± 3.6 ng ml⁻¹) to group 2 (9.1 ± 6.7 ng ml⁻¹) and group 3 (13.7 ± 7.6 ng ml⁻¹), with the difference reaching statistical significance in group 3 versus 1 and 2 (p < 0.001). A multivariable model of analysis demonstrated that the best predictors of plasma adiponectin were body mass index, N-terminal pro-brain natriuretic peptide and high-density lipoprotein cholesterol. However, even after adjusting for all three independent predictors, the increase of adiponectin in group 3 still remained statistically significant (p = 0.015).


CONCLUSIONS
Our data confirm the rise of adiponectin in overt HF. The levels of circulating adipokine seem to be mainly predicted by the metabolic profile of patients and by biohumoral indicators, rather than by clinical and echocardiographic indexes of HF severity.
Department of Critical Care Medicine and Surgery, Geriatric Medicine Unit, University of Florence, Azienda Ospedaliero-Universitaria Careggi-AOUC, Via delle Oblate N. 4, 50139 Florence, Italy. pesine@libero.it
S
S
Baldasseroni
E
E
Mannucci
F
F
Orso
C
C
Di Serio
A
A
Pratesi
N
N
Bartoli
G A
GA
Marella
C
C
Colombi
A
A
Foschini
P
P
Valoti
E
E
Mossello
S
S
Fumagalli
N
N
Marchionni
F
F
Tarantini
D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D016009:Chi-Square Distribution; D008076:Cholesterol, HDL / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010045:Outpatients; D010446:Peptide Fragments / Q000097:blood; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D013599:Systole; D015854:Up-Regulation; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000503:physiopathology; D016277:Ventricular Function, Left
C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers; D008076:Cholesterol, HDL; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain