Abstract 1677: Adiponectin as a Biomarker at Different Stages of Ischaemic Heart Disease: From Obesity to Ischaemic Heart Failure
Background: Adiponectin is downregulated in obesity, but the existing data regarding its role at different stages of ischaemic heart disease have been conflicting. We evaluated the impact of obesity and the different stages of ischaemic heart disease on circulating adiponectin levels.
Methods: The study population consisted of 746 individuals as follows: Healthy non-obese individuals (BMI40%, n=283), patients with ischaemic heart failure ((IHD), LV ejection fraction<40%, n=225) and patients with non-ischemic heart failure ((HF) LV ejection fraction<40% no CAD, n=34). Serum adiponectin was measured by ELISA in all study groups.
Results: Obesity was associated with lower adiponectin levels among healthy individuals (Fig.⇓). However, serum adiponectin was higher in CAD compared to obese or non-obese healthy individuals, while the development of heart failure induced a striking further elevation of serum adiponectin, independently of the existence of underlying coronary atherosclerosis (Fig.⇓). Adiponectin was correlated negatively with LV ejection fraction (r=−0.414, p=0.0001) but positively with the angiographic extend of CAD (rho=0.111, p=0.008).
Conclusions: Despite the down-regulation of adiponectin’s expression in obese individuals, its serum levels are elevated in patients with coronary artery disease, while the development of ischaemic- or non-ischaemic heart failure induces a striking up-regulation of adiponectin’s synthesis. This is the first comprehensive study demonstrating that further to obesity, the extent of coronary atherosclerosis as well as the development of heart failure are also key determinants of circulating adiponectin.