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European Journal of Heart Failure Advance Access originally published online on April 9, 2009
European Journal of Heart Failure 2009 11(6):567-572; doi:10.1093/eurjhf/hfp046
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

Adiponectin is increased in cardiac cachexia irrespective of body mass index

José Paulo Araújo*, Patrícia Lourenço, Francisco Rocha-Gonçalves, António Ferreira and Paulo Bettencourt

Heart Failure Clinic, Serviço de Medicina Interna—Hospital S. João, Faculdade de Medicina da Universidade do Porto, Unidade I&D Cardiovascular do Porto, Alameda Prof. Hernani Monteiro, 4202-451 Porto, Portugal

* Corresponding author. Tel: +35 122 551 2200, Fax: +35 122 551 2332, Email: pauloaraujo{at}iol.pt


  Abstract

Aims: 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.

Methods and results: 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 µg/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.

Conclusion: 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.

Key Words: Heart failure • Adiponectin • Leptin • Ghrelin • Adipocytokines • Cachexia

Received October 16, 2008; Revised February 28, 2009; Accepted March 3, 2009


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