The Changes And Clinical Significance Of Serum Adiponectin Concentrations In Patients With Chronic Heart Failure

Objective: To study the changes and clinical significance of serum adiponectin concentrations in patients with chronic heart failure (CHF).Methods: 64 hospitalized CHF patients in cardiovascular wards from Sept. 2008 to Jan. 2009 were selected, and then divided into 3 subgroups according to New York Heart Association (NYHA) functional class : NYHAⅡgroup (n=25), NYHAⅢgroup (n=21), and NYHAⅣgroup (n=18). The mean age was (69.55±8.59) years old, including 39 males and 25 females. Meanwhile, 21 paroxysmal supravetricular tachycardia (PSVT) hospitalized patients without structural heart diease were enrolled as control group, including 11 males and 10 females. The mean age was (52.90±12.68) years old. After a minimum 8-hour overnight fast and 20 minutes of supine rest, 2mL venous blood was drawn and centrifuged at a speed of 3000 runs/min for 15 minutes, 200μL serum was frozen at -70℃until analyses of adiponectin. Serum adiponectin concentration was measured by a sandwich ELISA method. High sensitive C-reactive protein (hs-CRP), serum glucose (Glu) and uric acid (UA) concentrations were measured by the probation department. All patients undertook echocardiography examination and LVEF were measured within three days after admission.Results:1. Compared with control group, CHF patients had significantly increased serum concentrations of adiponectin [(5.04±1.98)μg/mL, (11.96±5.39)μg/mL, respectively, p<0.001]. Serum adiponectin concentrations were significantly elevated according to the severity of the NYHA class in CHF patients [NYHAⅡgroup: (7.50±3.90)μg/mL, NYHA Ⅲgroup: (14.03±4.08)μg/mL, NYHAⅣgroup: (15.74±4.09)μg/mL, respectively, p<0.05]. Compared with NYHAⅡgroup, CHF patients in NYHAⅢgroup and NYHAⅣgroup had significantly increased serum concentrations of adiponectin (p<0.001). No significant difference was found in serum adiponectin concentrations between patients in NYHAⅢgroup and NYHAⅣgroup.2. Compared with control group, CHF patients had significantly increased serum concentrations of hs-CRP [(1.69±1.62)mg/L, (6.17±5.52)mg/L, respectively, p<0.001]. Serum hs-CRP concentrations were significantly elevated according to the severity of the NYHA class in CHF patients [NYHAⅡgroup: (4.43±3.63)mg/L, NYHAⅢgroup: (6.54±5.26)mg/L, NYHAⅣgroup: (8.16±6.33)mg/L, respectively, p<0.05]. Compared with NYHAⅡgroup, CHF patients in NYHAⅢgroup and NYHAⅣgroup had significantly increased serum concentrations of hs-CRP (p<0.05, p<0.01, respectively). CHF patients in NYHAⅣgroup had elevated concentrations of hs-CRP than NYHAⅢgroup (p<0.05). Compared with control group, CHF patients had significantly increased serum concentrations of UA [(295.38±65.78)μmol/L, (406.63±131.15)μmol/L, respectively, p<0.001]. Serum UA concentrations were significantly elevated according to the severity of the NYHA class in CHF patients [NYHAⅡgroup: (375.64±125.96)μmol/L, NYHAⅢgroup: (393.14±125.13)μmol/L, NYHAⅣgroup: (465.39±132.76)μmol/L, respectively, p<0.05]. Compared with NYHAⅡgroup and NYHAⅢgroup, CHF patients in NYHAⅣgroup had significantly increased serum concentrations of UA (p<0.05). No significant difference was found in serum UA concentrations between patients in NYHAⅡgroup and NYHAⅢgroup.3. No significant differences were found in serum adiponectin concentrations among patients with different basic cardiac disease of coronary heart diease (CHD), essential hypertension (EH) and dilated cardiomyopathy (DCM).4. Serum adiponectin concentration was positively correlated with hs-CRP (r=0.325, P=0.009) and UA concentrations (r=0.248, P=0.048), and negatively correlated with LVEF (r=-0.352, P=0.004). Conclusions:1. The serum adiponectin concentration was elevated with the severity of NYHA functional class in patients with CHF. Serum adiponectin levels could be considered as a biomarker of the severity of CHF. But serum adiponetin concentration in patients with CHF was not associated with the causes.2. The serum adiponectin concentration was positively correlated with serum hs-CRP and UA concentrations, this indicates the elevated concentration of adiponectin may play a role as anti-inflammation and anti-oxidative stress, and delay the progression of CHF.