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Adiponectin in chronic heart failure: influence of diabetes and genetic variants

Serge Masson1, Francesca Gori, Roberto Latini

  • 1Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy. serge.masson@marionegri.it

European Journal of Clinical Investigation
|June 1, 2011
PubMed

Insights

Higher adiponectin levels in chronic heart failure (CHF) patients predict poor prognosis, independent of type 2 diabetes (T2D) and body mass index (BMI). Genetic variants in the ADIPOQ gene influence adiponectin levels but not its prognostic value.

Area of Science:

  • Cardiology
  • Genetics
  • Metabolic Syndrome

Background:

  • Circulating adiponectin levels are influenced by type 2 diabetes (T2D) and body mass index (BMI).
  • The prognostic significance of adiponectin in chronic heart failure (CHF) requires further investigation, considering potential confounders.
  • The association between ADIPOQ gene variants and adiponectin concentration in CHF patients is not fully understood.

Purpose of the Study:

  • To investigate the association between ADIPOQ gene variants and circulating adiponectin levels in patients with CHF.
  • To evaluate the influence of T2D, BMI, and ADIPOQ gene variants on the prognostic value of adiponectin in CHF.
  • To determine the relationship between adiponectin concentration and mortality in CHF patients.

Main Methods:

  • Plasma adiponectin levels and four ADIPOQ gene single-nucleotide polymorphisms (SNPs) were analyzed in approximately 1200 CHF patients from the GISSI-HF trial.
  • Associations between adiponectin levels, ADIPOQ SNPs, clinical characteristics, and mortality were assessed.
  • The impact of T2D and other confounders on adiponectin's prognostic value was evaluated.

Main Results:

  • Adiponectin levels were inversely related to BMI, higher in women and older individuals, and lower in patients with diabetes.
  • Specific ADIPOQ gene variants (rs1501299 and rs17300539) were associated with significantly elevated adiponectin concentrations.
  • Baseline plasma adiponectin independently predicted mortality in CHF patients, irrespective of diabetes status, and improved risk prediction beyond established factors.
  • Increasing adiponectin levels over 3 months were associated with worse outcomes, though this association was attenuated by genetic variants and confounders.

Conclusions:

  • Circulating adiponectin levels, but not ADIPOQ genetic variants, are consistently associated with poor prognosis in CHF patients.
  • While diabetes and ADIPOQ gene variants affect adiponectin levels, elevated adiponectin is a significant predictor of mortality in CHF.
  • Adiponectin's prognostic value in CHF is robust but can be influenced by factors like T2D, BMI, and age.
Abstract

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