Abstract
Obesity, type 2 diabetes mellitus (DM) and metabolic syndrome (MS) are common in patients with heart failure (HF). Studies investigating the association between known biomarkers and adiposity in patient populations are limited. The aim of the present study was to investigate the association between C-reactive protein (CRP) and leptin with adiposity in a sub-group of overweight/obese patients with HF, DM and/or MS. A total of 36 patients (mean age, 56.72±9.78 years; ranging between 27 and 76 years of age; 80.6% male; 52.8% Caucasian) were enrolled and their height, weight, waist circumference and body composition (e.g. percentage body fat and lean mass), as well as the levels of CRP and leptin, were assessed. The results demonstrated that there was a significant association between CRP and leptin, CRP and body mass index (BMI) and gender and percentage body fat (P<0.05, for all associations). Analysis of leptin and CRP levels revealed that patients in the highest BMI quartile (BMI, 40.3–61.2) had higher CRP levels (4.83 μg/ml vs. 3.03 μg/ml; P=0.033) and higher leptin levels (44.97 ng/ml vs. 24.64 ng/ml; P=0.042) compared with patients in the lower BMI quartile (BMI, 28.6–32.4). In conclusion, among obese patients with HF, DM and/or MS, an association between CRP and leptin was identified, providing further evidence that metabolic and inflammatory mechanisms are involved in these diseases. Future investigation to assess the potential impact of inflammation and adiposity, and the role of dietary interventions and weight loss on clinical outcomes in this population of chronically ill patients is warranted.
Highlights
Heart failure (HF), obesity and type 2 diabetes mellitus (DM) are disease conditions associated with the progression of cardiovascular disease, functional disability and a diminished quality of life as reported in our recent study [1]
To the best of our knowledge, the present study is the first to examine the association between C‐reactive protein (CRP), leptin and adiposity and other cardiovascular risk factors in overweight/obese patients with HF, DM and/or metabolic syndrome (MS)
The moderately strong association between CRP and adiposity observed in the present study is in accordance with a previous study that linked adiposity with a chronic state of inflammation, which may be involved in the development of multiple chronic illnesses, including cardiovascular disease and MS [29]
Summary
Heart failure (HF), obesity and type 2 diabetes mellitus (DM) are disease conditions associated with the progression of cardiovascular disease, functional disability and a diminished quality of life as reported in our recent study [1]. Numerous contributing factors have been hypothesized to be involved in obesity‐linked metabolic and inflammatory alterations associated with cardiovascular disease. Two of these factors that have been implicated in each of these disease states are C‐reactive protein (CRP) and leptin. Elevated levels of CRP have been found to be associated with the development of coronary heart disease and metabolic syndrome (MS) [8,9,10,11]. Current evidence suggests that inflammation and biomarkers, including high‐sensitivity CRP, may be as important as cholesterol in determining the development of atherosclerosis and heart disease. Whilst obesity is one of the strongest determinants of CRP levels [12], the exact mechanism linking obesity and inflammation remains to be elucidated
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