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

Tatsuya Sawaguchi,Masashi Sakuma,Takafumi Nakajima,Akiko Haruyama,Hironaga Ogawa,Takaaki Hasegawa,Fumitaka Nakamura,Shigeru Toyoda,Hiroyuki Kaneda,Teruo Inoue,Takuo Arikawa,Shichiro Abe,Syotaro Obi,Ikuko Shibasaki,Yuusuke Takei,Toshiaki Nakajima,Hirotsugu Fukuda,Tatsuo Shimosawa

doi:10.1371/journal.pone.0225008

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.

Highlights

Adiponectin and leptin are well known to play important roles in regulating metabolic homeostasis and are linked to several pathophysiological conditions and diseases including cardiovascular disease (CVD)
Adiponectin had a negative correlation with anterior mid-thigh muscle thickness, skeletal muscle volume and skeletal muscle volume index (SMI). 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
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

Summary

Introduction

Adiponectin and leptin are well known to play important roles in regulating metabolic homeostasis and are linked to several pathophysiological conditions and diseases including cardiovascular disease (CVD). High levels of circulating adiponectin are known to have a favorable effect on metabolic processes and protect against derangements that lead to obesity, metabolic syndrome, atherosclerosis, and subsequently CVD [1,2,3]. Adiponectin and leptin play an important role in regulating cardiac function and are linked to several cardiac pathophysiological conditions and diseases, cardiac hypertrophy and heart failure. In contrast to the cardioprotective effects of adiponectin, high adiponectin levels have been reported to be associated with increased risk of recurrent cardiovascular events [14] and mortality in patients with acute myocardial infarction [15]. Cardiac cachexia and muscle wasting (sarcopenia) lead to increased levels of adiponectin in heart failure [20,21]

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