Association of adiponectin with peripheral muscle status in elderly patients with heart failure

• Published in: European journal of internal medicine Vol. 24; no. 8; pp. 818 - 823
• Main Authors: Loncar, Goran, Bozic, Biljana, von Haehling, Stephan, Düngen, Hans-Dirk, Prodanovic, Nenad, Lainscak, Mitja, Arandjelovic, Aleksandra, Dimkovic, Sinisa, Radojicic, Zoran, Popovic, Vera
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-12-2013
• Subjects: Absorptiometry, Photon; Adiponectin; Adiponectin - blood; Aged; Biomarkers - blood; Body Composition; Case-Control Studies; Chronic heart failure; Hand Strength - physiology; Heart Failure - blood; Heart Failure - physiopathology; Humans; Internal Medicine; Male; Middle Aged; Multivariate Analysis; Muscle mass; Muscle strength; Muscle Strength Dynamometer; Muscle Weakness - blood; Muscle Weakness - diagnostic imaging; Muscle Weakness - physiopathology; Muscle, Skeletal - diagnostic imaging; Muscle, Skeletal - physiopathology; Regression Analysis; high sensitivity C-reactive protein; NT-pro-BNP; heart failure; parathyroid hormone; RANKL; Muscle strength; PTH; LVEF; Chronic heart failure; left ventricular ejection fraction; Adiponectin; 25(OH)D; 25-hydroxy vitamin D; hs-CRP; receptor activator of nuclear factor κB ligand; HF; N-terminal pro-brain natriuretic peptide; Muscle mass
• ISSN: 0953-6205; 1879-0828
• DOI: 10.1016/j.ejim.2013.09.011

Abstract Background Reduced peripheral muscle mass was demonstrated in patients with chronic heart failure (HF). Adipokines may have potent metabolic effects on skeletal muscle. The associations between adipokines, peripheral muscle mass, and muscle function have been poorly investigated in patients with HF. Methods We measured markers of fat and bone metabolism (adiponectin, leptin, 25-hydroxy vitamin D, parathyroid hormone, osteoprotegerin, RANKL), N-terminal pro B-type natriuretic peptide (NT-pro-BNP) in 73 non-cachectic, non-diabetic, male patients with chronic HF (age: 68 ± 7 years, New York Heart Association class II/III: 76/26%, left ventricular ejection fraction 29 ± 8%) and 20 healthy controls of similar age. Lean mass as a measure of skeletal muscle mass was measured by dual energy X-ray absorptiometry (DEXA), while muscle strength was assessed by hand grip strength measured by Jamar dynamometer. Results Serum levels of adiponectin, parathyroid hormone, osteoprotegerin, RANKL, and NT-pro-BNP were elevated in patients with chronic HF compared to healthy controls (all p < 0.0001), while no difference in serum levels of leptin, testosterone or SHBG was noted. Levels of 25-hydroxy vitamin D were reduced (p = 0.002) in HF group. Peripheral lean mass and hand grip strength were reduced in patients with HF compared to healthy subjects (p = 0.006 and p < 0.0001, respectively). Using backward selection multivariable regression, serum levels of increased adiponectin remained significantly associated with reduced arm lean mass and muscle strength. Conclusions Our findings may indicate a cross-sectional metabolic association of increased serum adiponectin with reduced peripheral muscle mass and muscle strength in non-cachectic, non-diabetic, elderly HF patients.