title: The effect of BMI, serum leptin, and adiponectin levels on prognosis in patients with non-ischaemic dilated cardiomyopathy.
abstract: BACKGROUND
  The recent studies demonstrated that obese heart failure patients have better prognosis - "obesity paradox". The aim of the study was to evaluate the relationship between body mass index (BMI), leptin and adiponectin concentrations and prognosis in patients with heart failure due to non ischeamic dilated cardiomyopathy (NIDCM).
  
  
  METHODS
  128 patients with NIDCM were included and followed-up for three years. Leptin and adiponectin were measured at baseline using commercially available ELISA tests. Clinical data, routine laboratory parameters, NT-proBNP were assessed as risk factors for reaching the study endpoints: urgent heart transplantation (B), death (C), or combined endpoint death or urgent heart transplantation (D).
  
  
  RESULTS
  Patient with adverse outcome had lower BMI and higher NT-proBNP concentration. Leptin was significantly elevated in group C and adiponectin was higher in groups B and D than in survived patients. Patients with leptin concentration below median or with adiponectin concentration above median were more often transplanted in three years follow-up (p = 0.029, p = 0.022, respectively). The cumulative probability of death was greater in patients with concentration of leptin above median (p = 0.024). In the multivariable Cox proportional hazards analyses, increasing leptin and lower BMI were predictors of death. Adiponectin was associated with higher risk of heart transplantation. Both an inverse association of BMI and positive association of leptin and adiponectin with combined endpoint were discovered. Further adjustment to established risk factors abolished association between combined endpoint and BMI, and modestly attenuate with adiponectin and leptin concentration.
  
  
  CONCLUSIONS
  Evaluation of adiponectin and leptin concentrations was more useful than BMI in prediction of unfavourable outcome in patients with NIDCM. (Endokrynol Pol 2017; 68 (1): 26-34).
authors.affiliation: Second Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland. wojciechowskac@wp.pl.
authors.forename: Celina
authors.initials: C
authors.lastname: Wojciechowska
authors.forename: Wojciech
authors.initials: W
authors.lastname: Jacheć
authors.forename: Ewa
authors.initials: E
authors.lastname: Romuk
authors.forename: Ewa
authors.initials: E
authors.lastname: Nowalany-Kozielska
authors.forename: Andrzej
authors.initials: A
authors.lastname: Tomasik
authors.forename: Lucyna
authors.initials: L
authors.lastname: Siemińska
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000328:Adult; D015992:Body Mass Index; D002311:Cardiomyopathy, Dilated / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D020738:Leptin; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: BMI; adiponectin; dilated cardiomyopathy; heart failure; leptin