Serum adiponectin level as an independent predictor of mortality in patients with congestive heart failure.
Serum adiponectin level as an independent predictor of mortality in patients with congestive heart failure.
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DOI：
10.1253/circj.71.623
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发表时间：
2007-04
期刊：
影响因子：
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通讯作者：
T. Tamura;Y. Furukawa;R. Taniguchi;Yukihito Sato;K. Ono;H. Horiuchi;Y. Nakagawa;T. Kita;Takeshi Kimura
中科院分区：
文献类型：
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作者：
T. Tamura;Y. Furukawa;R. Taniguchi;Yukihito Sato;K. Ono;H. Horiuchi;Y. Nakagawa;T. Kita;Takeshi Kimura
充血性心力衰竭（CHF）与能量稳态改变和心肌炎症、肥大和纤维化有关。脂联素是一种胰岛素增敏性脂肪细胞因子，可影响上述致病因素，循环脂联素水平可作为CHF的生物学标志物。本研究旨在评估血清脂联素作为日本CHF患者预后标志物的意义。方法和结果比较了54例（24例缺血性和30例非缺血性）CHF伴左室收缩功能障碍患者和55例年龄和性别匹配的对照组的血清脂联素水平。CHF患者还同时进行了临床评估和脑钠肽（BNP）和脂质或葡萄糖代谢参数的测量。与对照组相比，CHF患者血清脂联素水平显著升高[6.7（4.9-12.6）vs 14.6（9.7-25.4）μ g/ml，p<0.0001]。在CHF患者中，血清脂联素水平的对数转换值与血浆BNP水平的对数转换值呈正相关（p=0.0003，r=0.48），与体重指数呈负相关（p=0.0006，r=-0.46）。此外，血清脂联素水平升高与较高的死亡率相关（p<0.05），尤其是在缺血性CHF患者中（p<0.005）。结论：循环脂联素水平升高与缺血性CHF患者死亡率升高相关。脂联素可能是日本CHF患者的一个信息性风险标志物。
BACKGROUND Congestive heart failure (CHF) is associated with altered energy homeostasis and myocardial inflammation, hypertrophy, and fibrosis. Adiponectin, an insulin-sensitizing adipocytokine, may affect these pathogenic factors, and the circulating adiponectin level may serve as a biological marker of CHF. This study aimed to assess the significance of serum adiponectin as a prognostic marker for Japanese CHF patients. METHODS AND RESULTS The serum adiponectin levels were compared between 54 (24 ischemic and 30 non-ischemic) CHF patients with left ventricular systolic dysfunction and 55 age- and gender-matched control subjects. The CHF patients also underwent simultaneous clinical assessment and measurements for brain natriuretic peptide (BNP) and parameters of lipid or glucose metabolism. Compared with the controls, the CHF patients showed significantly increased serum adiponectin levels [6.7 (4.9-12.6) vs 14.6 (9.7-25.4) microg/ml, p<0.0001]. In the CHF patients, the log-transformed values of the serum adiponectin levels positively correlated with the log-transformed values of the plasma BNP levels (p=0.0003, r=0.48) and inversely correlated with the body mass index (p=0.0006, r=-0.46). Furthermore, an increase in the serum adiponectin level was associated with higher mortality (p<0.05), particularly in the ischemic CHF patients (p<0.005). CONCLUSIONS An increase in the circulating adiponectin level was associated with higher mortality in the ischemic CHF patients. Adiponectin may be an informative risk marker for Japanese CHF patients.