Adiponectin is increased in cardiac cachexia irrespective of body mass index
Adiponectin is increased in cardiac cachexia irrespective of body mass index
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DOI：
10.1093/eurjhf/hfp046
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发表时间：
2009-06-01
影响因子：
18.2
通讯作者：
Bettencourt, Paulo
中科院分区：
文献类型：
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作者：
Paulo Araujo, Jose;Lourenco, Patricia;Bettencourt, Paulo
心脏恶病质（CC）是慢性心力衰竭（CHF）的并发症。脂联素、瘦素和胃饥饿素是能量代谢和体重的重要调节因子。CHF和CC的既往研究表明，病毒质和非病毒质患者的体重指数（BMI）有很大差异。评估恶病质和非恶病质患者血清脂联素、瘦素和胃饥饿素浓度。我们在BMI匹配的CHF患者中进行了一项病例对照研究。病例（n = 33）为病毒症患者，意外体重减轻>=先前基线体重的7.5%。对照组（n = 33）没有体重减轻史，并根据年龄、性别和BMI分别与病例匹配。病毒症患者脂联素水平显著高于对照组：25.0 +/- 12.3 vs. 14.7 +/- 8.8 μ g/mL （P = 0.002）。病毒质组瘦素浓度较低：7.5 (IQR 4.0-10.8) vs 8.0 (IQR 7.1-10.5) ng/mL。一旦根据脂肪量进行调整，瘦素的差异就失去了意义。调整后，脂联素在病毒学中仍保持较高水平。Ghrelin组间差异无统计学意义。脂联素与减肥和BNP呈正相关。慢性心力衰竭患者的恶病质与脂联素升高有关，与BMI无关。这表明脂联素在恶病质患者的消耗过程中起作用。
Cardiac cachexia (CC) is a complication of chronic heart failure (CHF). Little is known about the mechanisms leading to CC. Adiponectin, leptin, and ghrelin are important regulators of energy metabolism and body weight. Previous studies of CHF and CC had great differences in body mass index (BMI) between cachectic and non-cachectic patients. To assess serum adiponectin, leptin, and ghrelin concentrations in cachectic and non-cachectic patients.We conducted a case-control study in CHF patients matched for BMI. Cases (n = 33) were cachectic patients with unintentional weight loss of >= 7.5% of the previous baseline weight. Controls (n = 33) had no history of weight loss and were individually matched with cases for age, sex, and BMI. Cachectic patients had significantly higher adiponectin levels than controls: 25.0 +/- 12.3 vs. 14.7 +/- 8.8 mu g/mL (P = 0.002). Leptin concentration was lower in the cachectic group: 7.5 (IQR 4.0-10.8) vs. 8.0 (IQR 7.1-10.5) ng/mL. Differences in leptin lost significance once adjusted for fat mass. Adiponectin remained higher in cachectics after such adjustment. Ghrelin was not significantly different between groups. Adiponectin correlated positively with weight loss and BNP.Cachexia in CHF was associated with an increase in adiponectin, irrespective of BMI. This suggests a role of adiponectin in the wasting process of cachectic patients.