title: Orosomucoid as prognosis factor associated with inflammation in acute or nutritional status in chronic heart failure.
abstract: BACKGROUND
  Inflammation and nutritional state are involved in the pathogenesis of heart failure (HF).
  
  
  OBJECTIVE
  To study the contribution of alpha-1-acid-glycoprotein (AGP) to these factors and its prognostic value in acute (AHF) or chronic HF (CHF).
  
  
  METHODS
  The observational study has included 147 patients (mean age 70years, 62% men) admitted to a cardiology department for HF and followed-up for an average 326.6±140.8days. Blood AGP values were measured by Enzyme-Linked ImmunoSorbent Assay. Monocytes subsets were determined with CD14 and CD16 antibodies by flow cytometry and body composition was measured by dual-energy X-ray absorptiometry. The regulation of tumor necrosis factor (TNF-α) and leptin by AGP in epicardial adipose tissue (EAT) were analyzed by real time polymerase chain reaction.
  
  
  RESULTS
  High AGP, that was associated with CD14+CD16+monocytes, and proBNP levels at the discharge were indicators of rehospitalization for HF in AHF patients. However, low AGP levels determined a worse nutritional state in CHF patients. The leptin levels were downregulated by high AGP concentration in epicardial fat.
  
  
  CONCLUSIONS
  AGP is a dual indicator in HF because high levels are predictors of adverse outcomes in AHF but low levels are related to the worse nutritional status in CHF. The regulation of leptin by AGP in epicardial fat might suggest a new pathway as protective mechanism in CHF.
authors.affiliation: Cardiovascular Area and Coronary Unit, Complejo Hospitalario Universitario de Santiago de Compostela, Spain; Cardiology Group, Health Research Institute of Santiago de Compostela, Spain.
authors.forename: Rosa M
authors.initials: RM
authors.lastname: Agra
authors.affiliation: Cardiovascular Area and Coronary Unit, Complejo Hospitalario Universitario de Santiago de Compostela, Spain; Cardiology Group, Health Research Institute of Santiago de Compostela, Spain.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Varela-Román
authors.affiliation: Cardiovascular Area and Coronary Unit, Complejo Hospitalario Universitario de Santiago de Compostela, Spain.
authors.forename: Rocío
authors.initials: R
authors.lastname: González-Ferreiro
authors.affiliation: Immunology Unit, Complejo Hospitalario Universitario de Santiago de Compostela, Spain.
authors.forename: Juan E
authors.initials: JE
authors.lastname: Viñuela
authors.affiliation: CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Castro-Pais
authors.affiliation: Cardiology Group, Health Research Institute of Santiago de Compostela, Spain.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Fernández-Trasancos
authors.affiliation: Cardiology Group, Health Research Institute of Santiago de Compostela, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Díaz-Rodríguez
authors.affiliation: Cardiology Group, Health Research Institute of Santiago de Compostela, Spain.
authors.forename: Ezequiel
authors.initials: E
authors.lastname: Álvarez
authors.affiliation: CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Marcos C
authors.initials: MC
authors.lastname: Carreira
authors.affiliation: CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Laboratory of Molecular and Cellular Endocrinology, Department of Medicine, Endocrinology Division, University of Santiago de Compostela and Complejo Hospitalario Universitario, Santiago de Compostela, Spain.
authors.forename: Felipe F
authors.initials: FF
authors.lastname: Casanueva
authors.affiliation: Cardiovascular Area and Coronary Unit, Complejo Hospitalario Universitario de Santiago de Compostela, Spain; Cardiology Group, Health Research Institute of Santiago de Compostela, Spain.
authors.forename: José R
authors.initials: JR
authors.lastname: González-Juanatey
authors.affiliation: Cardiology Group, Health Research Institute of Santiago de Compostela, Spain. Electronic address: sonia.eiras.penas@sergas.es.
authors.forename: Sonia
authors.initials: S
authors.lastname: Eiras
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001823:Body Composition; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006333:Heart Failure / Q000097:blood*; D006801:Humans; D007249:Inflammation / Q000097:blood*; D008297:Male; D009000:Monocytes / Q000378:metabolism; D009752:Nutritional Status; D009961:Orosomucoid / Q000378:metabolism*; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D009961:Orosomucoid
keywords: AGP; Epicardial adipose tissue; Heart failure; Inflammation