Determinants of adiponectin levels in patients with chronic systolic heart failure

Adiponectin, an adipocytokine, is secreted by adipocytes and mediates antihypertrophic and anti-inflammatory effects in the heart. Plasma concentrations of adiponectin are decreased in the presence of obesity, insulin resistance, and obesity-associated conditions such as hypertension and coronary heart disease. However, a paradoxical increase in adiponectin levels is observed in human systolic heart failure (HF). We sought to investigate the determinants of adiponectin levels in patients with chronic systolic HF. Total adiponectin levels were measured in 99 patients with stable HF and a left ventricular (LV) ejection fraction of <40%. The determinants of adiponectin levels on univariate analysis were included in a multivariate linear regression model. At baseline, 62% of the patients were black, 63% were men, the mean age was 60 + or - 13 years, the LV ejection fraction was 21 + or - 9%, and the body mass index was 30.6 + or - 6.7 kg/m(2). The mean adiponectin level was 15.8 + or - 15 microg/ml. Beta-Blocker use, body mass index, and blood urea nitrogen were significant determinants of adiponectin level on multivariate analysis. The LV mass, structure, and LV ejection fraction were not related to adiponectin levels on multivariate analysis. The effect of beta-blocker therapy was most marked in nonobese patients with a body mass index <30 kg/m(2). In conclusion, in patients with chronic systolic HF, beta-blocker therapy correlated with lower adiponectin levels, especially in nonobese patients. This relation should be taken into account when studying the complex role of adiponectin in patients with chronic systolic HF.