Association of serum leptin and adiponectin concentrations with echocardiographic parameters and pathophysiological states in patients with cardiovascular disease receiving cardiovascular surgery

Abstract

Leptin and adiponectin are important regulators of energy metabolism and body composition. Leptin exerts cardiodepressive effects, whereas adiponectin has cardioprotective effects, but several conflicting findings have been reported. The aim of the present study was to assess the relationship between serum leptin and adiponectin levels and echocardiographic parameters and pathophysiological states in patients with cardiovascular disease (CVD) receiving cardiovascular surgery. A total of 128 patients (79 males, average age 69.6 years) that had surgery for CVD including coronary artery bypass graft (CABG) and valve replacement were recruited in this study. Preoperative serum adiponectin and leptin concentrations were measured by enzyme-linked immunosorbent assay and compared with preoperative echocardiographic findings. Body fat volume and skeletal muscle volume index (SMI) were estimated using bioelectrical impedance analysis. We also measured grip strength and gait speed. Sarcopenia was diagnosed based on the recommendations of the Asian Working Group on Sarcopenia. Positive correlations were found between adiponectin and brain natriuretic peptide (BNP), age, left atrial diameter (LAD), E/e’ (early-diastolic left ventricular inflow velocity / early-diastolic mitral annular velocity), and left atrial volume index (LAVI). Negative correlations were observed between adiponectin and body mass index (BMI), estimated glomerular filtration rate (eGFR), triglyceride, hemoglobin, and albumin. Serum leptin was positively correlated with BMI, total cholesterol, triglyceride, albumin, body fat volume, and LV ejection fraction (LVEF), whereas it was negatively correlated with BNP and echocardiographic parameters (LAD, LV mass index (LVMI), and LAVI). Multiple regression analysis showed associations between log (leptin) and log (adiponectin) and echocardiographic parameters after adjusting for age, sex, and BMI. Serum adiponectin was negatively correlated with leptin, but positively correlated with tumor necrosis factor α (TNFα), an inflammatory cytokine. In males, serum leptin level had a positive correlation with skeletal muscle volume and SMI. However, adiponectin had a negative correlation with anterior mid-thigh muscle thickness, skeletal muscle volume and SMI. And, it was an independent predictive factor in males for sarcopenia even after adjusted by age. These results suggest that leptin and adiponectin may play a role in cardiac remodeling in CVD patients receiving cardiovascular surgery. And, adiponectin appears to be a marker of impaired metabolic signaling that is linked to heart failure progression including inflammation, poor nutrition, and muscle wasting in CVD patients receiving cardiovascular surgery.

Energy Metabolism and Nutritional Status in Hospitalized Patients with Chronic Heart Failure

“…Inflammatory cytokines may have little effect on energy metabolism in patients with heart failure up to NYHA functional class III. It has been reported that SMI and leptin are positively correlated in heart failure patients [18], which is consistent with our results (Fig. 3b).…”

“…Conversely, leptin is secreted from adipocytes to suppress food intake and increase energy metabolism [15,17]. In recent report, serum leptin level had a positive correlation with skeletal muscle volume and skeletal muscle index (SMI) [18] and was expected to have cardioprotective effects [19][20][21]. However, the relationship between leptin and energy metabolism has not been explored.…”

Relationship Between Body Fat and Morbidity and Mortality in Cardiac Surgery

“…In a study of patients undergoing cardiac surgery, leptin was positively correlated with BMI and fat mass, and negatively with the size of the left atrium and cardiac mass index, while adiponectin was positively correlated with the size of the left atrium and E/e'. (27) According to the authors, it suggests that both markers can participate in cardiac remodeling after cardiovascular surgery and thus impact on the prognosis.…”

Association of Adiponectin, Leptin and Resistin Plasma Concentrations with Echocardiographic Parameters in Patients with Coronary Artery Disease

“…The relationships between adiponectin level and left ventricular systolic and diastolic dysfunction have also been studied by other authors. The inverse association of adiponectin level with LVEF was indicated in elderly men [53] or with LVSF in patients with hypertrophic cardiomyopathy [54], but other studies in patients with HF did not confirm this [55][56][57]. Additional evidence confirms that adiponectin levels are positively correlated with indicators of diastolic dysfunction: left ventricular pressure half-time in patients with hypertrophic cardiomyopathy [58], E/E' ratio in HF patients with metabolic syndrome [55] or CVD patients [57] and DT in CAD patients [59].…”