Adiponectin is increased in cardiac cachexia irrespective of body mass index.

Aims: Cardiac cachexia (CC) is a complication of chronic heart failure (CHF). Little is known about the mechanisms leading to CC. Adiponectin, leptin, and ghrelin are important regulators of energy metabolism and body weight. Previous studies of CHF and CC had great differences in body mass index (BMI) between cachectic and non-cachectic patients. To assess serum adiponectin, leptin, and ghrelin concentrations in cachectic and non-cachectic patients.
Methods and Results: We conducted a case-control study in CHF patients matched for BMI. Cases (n = 33) were cachectic patients with unintentional weight loss of > or = 7.5% of the previous baseline weight. Controls (n = 33) had no history of weight loss and were individually matched with cases for age, sex, and BMI. Cachectic patients had significantly higher adiponectin levels than controls: 25.0 +/- 12.3 vs. 14.7 +/- 8.8 microg/mL (P = 0.002). Leptin concentration was lower in the cachectic group: 7.5 (IQR 4.0-10.8) vs. 8.0 (IQR 7.1-10.5) ng/mL. Differences in leptin lost significance once adjusted for fat mass. Adiponectin remained higher in cachectics after such adjustment. Ghrelin was not significantly different between groups. Adiponectin correlated positively with weight loss and BNP.
Conclusion: Cachexia in CHF was associated with an increase in adiponectin, irrespective of BMI. This suggests a role of adiponectin in the wasting process of cachectic patients.