Plasma adiponectin in heart failure with and without cachexia: Catabolic signal linking catabolism, symptomatic status, and prognosis

Background and aims: Adiponectin (ADPN) as an adipose tissue hormone contributes to regulation of energy metabolism and body composition and is associated with cardiovascular risk profile parameters. Cardiac cachexia may develop as a result of severe catabolic derangement in chronic heart failure (CHF). We aimed to determinate an abnormal ADPN regulation as a link between catabolic signalling, symptomatic deterioration and poor prognosis. Methods and results: We measured plasma ADPN in 111 CHF patients (age 65±11, 90% male, left ventricular ejection fraction (LVEF) 36±11%, peak oxygen consumption (peakVO₂) 18.1±5.7l/kg*min, body mass index (BMI) 27±4 kg/m², all mean±standard deviation) and 36 healthy controls of similar age and BMI. Body composition was assessed by dual energy X-ray absorptiometry, insulin sensitivity was evaluated by homoeostasis model assessment, exercise capacity by spiroergometry. Plasma ADPN did not differ between CHF vs. controls (13.5±11.0 vs. 10.5±5.3 mg/l, p>0.4), but increased stepwise with NYHA functional class (I/II/III: 5.7±1.4/10.7±8.3/19.2±14.0 mg/l, ANOVA p2 at anaerobic threshold (r=-0.34, p