Abstract
to determine the role of adipokines and vascular remodeling in formation of osteoporosis in idiopathic pulmonary arterial hypertension (IPAH). Functional and hemodynamic parameters, bone mineral density (BMD) T-score in lumbar spine (LS) and femoral neck (FN), blood serum levels of leptin, adiponectin, visfatin and endothelin-1 were measured in 27 patients with severe IPAH and 30 healthy volunteers. Half of IPAH patients had osteoporosis. Serum levels of leptin, adiponectin, visfatin and endothelin-1 in IPAH group were higher than in healthy volunteers. BMD T-score was directly related to results of 6‑minute walk test and inversely related to pulmonary vascular resistance (PVR). Circulating adiponectin and visfatin concentrations correlated with PVR; endothelin-1 concentration was directly related to pulmonary arterial systolic pressure, cardiac index and PVR. Relations between BMD T-score and circulating adiponectin, visfatin, and endothelin-1 were inverse. Positive correlations existed between serum adiponectin, visfatin and endothelin-1 levels. Results of our study confirm the important role of adipokine and endotheline dysregulation in development of hemodynamic disorders in severe IPAH and evidence for their possible involvement in formation of osteopenic syndrome.
Highlights
visfatin and endothelin-1 were measured in 27 patients with severe idiopathic pulmonary arterial hypertension (IPAH)
bone mineral density (BMD) T-score was directly related to results of 6‐minute walk test
Circulating adiponectin and visfatin concentrations correlated with pulmonary vascular resistance (PVR)
Summary
ИЛГ – идиопатическая легочная гипертензия; ИМТ – индекс массы тела; ИЖМ – индекс жировой массы; ОФВ1 – объем форсированного выдоха за 1‐ю секунду; СДЛА – среднее давление в легочной артерии; ОЛСС – общее легочное сосудистое сопротивление; ТШХ – тест с 6‐минутной ходьбой; ФК – функциональный класс; FN – шейка бедренной кости; LS – поясничный отдел позвоночника; ЭТ-1 – эндотелин-1. Исходя из доказанной роли адипокинов в регуляции статуса питания, выявлены прямые связи между ИМТ, ИЖМ и уровнем лептина в сыворотке (r=0,393; p=0,042 и r=0,565; p=0,002 соответственно) и положительные корреляции ИЖМ с содержанием адипонектина (r=0,444; p=0,020) и висфатина (r=0,506; p=0,007).
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