open access

Vol 68, No 1 (2017)
Original papers
Published online: 2017-03-01
Submitted: 2016-02-02
Accepted: 2016-03-02
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The effect of BMI, serum leptin, and adiponectin levels on prognosis in patients with non-ischaemic dilated cardiomyopathy

Celina Wojciechowska, Wojciech Jacheć, Ewa Romuk, Ewa Nowalany-Kozielska, Andrzej Tomasik, Lucyna Siemińska
DOI: 10.5603/EP.2017.0005
·
Endokrynologia Polska 2017;68(1):26-34.

open access

Vol 68, No 1 (2017)
Original papers
Published online: 2017-03-01
Submitted: 2016-02-02
Accepted: 2016-03-02

Abstract

Introduction: The recent studies demonstrated that obese heart failure patients have better prognosis — “obesity paradox”. The aim of the study was to evaluate the relationship between body mass index (BMI), leptin and adiponectin concentrations and prognosis in patients with heart failure due to non ischeamic dilated cardiomyopathy (NIDCM).

Material and methods: 128 patients with NIDCM were included and followed-up for three years. Leptin and adiponectin were measured at baseline using commercially available ELISA tests. Clinical data, routine laboratory parameters, NT–proBNP were assessed as risk factors for reaching the study endpoints: urgent heart transplantation (B), death (C), or combined endpoint death or urgent heart transplantation (D).

Results: Patient with adverse outcome had lower BMI and higher NT-proBNP concentration. Leptin was significantly elevated in group C and adiponectin was higher in groups B and D than in survived patients. Patients with leptin concentration below median or with adiponectin concentration above median were more often transplanted in three years follow-up (p = 0.029, p = 0.022, respectively). The cumulative probability of death was greater in patients with concentration of leptin above median (p = 0.024). In the multivariable Cox proportional hazards analyses, increasing leptin and lower BMI were predictors of death. Adiponectin was associated with higher risk of heart transplantation. Both an inverse association of BMI and positive association of leptin and adiponectin with combined endpoint were discovered. Further adjustment to established risk factors abolished association between combined endpoint and BMI, and modestly attenuate with adiponectin and leptin concentration.

Conclusion: Evaluation of adiponectin and leptin concentrations was more useful than BMI in prediction of unfavourable outcome in patients with NIDCM. (Endokrynol Pol 2017; 68 (1): 26–34)

Abstract

Introduction: The recent studies demonstrated that obese heart failure patients have better prognosis — “obesity paradox”. The aim of the study was to evaluate the relationship between body mass index (BMI), leptin and adiponectin concentrations and prognosis in patients with heart failure due to non ischeamic dilated cardiomyopathy (NIDCM).

Material and methods: 128 patients with NIDCM were included and followed-up for three years. Leptin and adiponectin were measured at baseline using commercially available ELISA tests. Clinical data, routine laboratory parameters, NT–proBNP were assessed as risk factors for reaching the study endpoints: urgent heart transplantation (B), death (C), or combined endpoint death or urgent heart transplantation (D).

Results: Patient with adverse outcome had lower BMI and higher NT-proBNP concentration. Leptin was significantly elevated in group C and adiponectin was higher in groups B and D than in survived patients. Patients with leptin concentration below median or with adiponectin concentration above median were more often transplanted in three years follow-up (p = 0.029, p = 0.022, respectively). The cumulative probability of death was greater in patients with concentration of leptin above median (p = 0.024). In the multivariable Cox proportional hazards analyses, increasing leptin and lower BMI were predictors of death. Adiponectin was associated with higher risk of heart transplantation. Both an inverse association of BMI and positive association of leptin and adiponectin with combined endpoint were discovered. Further adjustment to established risk factors abolished association between combined endpoint and BMI, and modestly attenuate with adiponectin and leptin concentration.

Conclusion: Evaluation of adiponectin and leptin concentrations was more useful than BMI in prediction of unfavourable outcome in patients with NIDCM. (Endokrynol Pol 2017; 68 (1): 26–34)

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Keywords

leptin; adiponectin; BMI; dilated cardiomyopathy; heart failure

About this article
Title

The effect of BMI, serum leptin, and adiponectin levels on prognosis in patients with non-ischaemic dilated cardiomyopathy

Journal

Endokrynologia Polska

Issue

Vol 68, No 1 (2017)

Pages

26-34

Published online

2017-03-01

DOI

10.5603/EP.2017.0005

Bibliographic record

Endokrynologia Polska 2017;68(1):26-34.

Keywords

leptin
adiponectin
BMI
dilated cardiomyopathy
heart failure

Authors

Celina Wojciechowska
Wojciech Jacheć
Ewa Romuk
Ewa Nowalany-Kozielska
Andrzej Tomasik
Lucyna Siemińska

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