Clinical Investigation
Relationship Between High Circulating Adiponectin With Bone Mineral Density and Bone Metabolism in Elderly Males With Chronic Heart Failure

https://doi.org/10.1016/j.cardfail.2009.12.015Get rights and content

Abstract

Background

The aim of the study was to investigate the associations of adiponectin and leptin to bone mass and bone specific surrogates in elderly males with chronic heart failure (CHF).

Methods and Results

Seventy-three males (mean age 68 ± 7 years) with stable mild to moderate CHF and 20 healthy individuals age- and body mass index–matching underwent dual energy x-ray absorptiometry measurements (bone mineral density (BMD) at hip and lumbar spine, total bone mineral content, and body composition); echocardiography; 6-minute walk test; grip strength; and biochemical assessment including adiponectin, leptin, bone specific surrogates (osteocalcin, β-CrossLaps, osteoprotegerin [OPG], receptor activator of nuclear factor κB ligand [RANKL]), parathyroid hormone, 25-hydroxy vitamin D, testosterone, sex hormone-binding globulin, and NT-pro-BNP. Serum adiponectin, osteocalcin, β-CrossLaps, OPG, RANKL, and parathyroid hormone were significantly increased in CHF patients, whereas 25-hydroxy vitamin D was significantly lower compared to healthy controls. The significant positive association was found between adiponectin level with osteocalcin, β-CrossLaps, OPG, and RANKL among CHF patients. In multivariate regression analysis, adiponectin was a significant determinant of total hip BMD, although the variance was small (r2 = 0.239), whereas leptin was determinant for total bone mineral content (r2 = 0.469) in patients with CHF.

Conclusions

Serum adiponectin is an independent predictor of BMD in elderly males with mild to moderate CHF, and showed a positive correlation to bone specific surrogates. Adiponectin, as cardioprotective hormone, seems to be able to exert a negative effect on bone mass in chronic heart failure. Further research is needed to confirm the potential for adipokines in the crosstalk between bone and energy metabolism in CHF patients.

Section snippets

Study Design

Having reviewed medical history archives of the Cardiology Department, Clinical Medical Center Zvezdara Belgrade, first contacts with eligible patients were made on the phone. For the baseline visit we screened 152 males aged 55 years and above with CHF from ischemic or idiopathic dilated cardiomyopathy. Following the baseline visit, 73 patients were included all of whom met the study inclusion and exclusion criteria. Inclusion criteria were: 1. duration of CHF for longer than 1 year; 2.

Demographic and Clinical Characteristics of CHF Patients and Healthy Subjects

The general characteristics of CHF patients and healthy subjects are summarized in Table 1. Compared to healthy subjects, CHF patients have lower left ventricular ejection fraction, 6-minute walking distance and grip strength, but higher left ventricular diameter. No difference in waist, waist/hip ratio, and body mass index was found between CHF patients and healthy subjects.

Biohumoral Variables of CHF Patients and Healthy Subjects

The biohumoral variables are presented in Table 2. CHF patients had significantly higher serum adiponectin, NT-pro-BNP,

Discussion

As far as we know, this is the first report of an association between adiponectin with BMD and bone specific surrogates in CHF patients. Our main finding is that increased adiponectin levels were independently associated with hip BMD in elderly men with mild to moderate CHF. Moreover, increased adiponectin is positively correlated with bone specific surrogates (osteocalcin, β-CrossLaps, RANKL, and OPG) in CHF patients. These findings support the hypothesis that adiponectin may play a

Acknowledgments

We thank Mrs M. Argirovic from MSD for support during application procedure for educational grant. This work was also supported by biochemical laboratory “Zavod za laboratorijsku dijagnostiku Konzilijum” Belgrade.

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    Supported by Serbian Ministry of Science (grant 145019), by Merck Sharp & Dohme unrestricted educational grant and by biochemical laboratory “Zavod za laboratorijsku dijagnostiku Konzilijum” Belgrade.

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