Leptin, Galectin-3 and Angiotensin II Type 1 Receptor Polymorphism in Overweight and Obese Patients with Heart Failure – Role and Functional Interplay

Alexandra Dadarlat-Pop,1 Dana Pop,1,2 Lucia Procopciuc,3 Adela Sitar-Taut,4 Dumitru Zdrenghea,1,2 Gyorgy Bodizs,2 Raluca Tomoaia,1 Diana Gurzau,1 Florina Fringu,1 Silvana Susca-Hojda,1 Anca D Buzoianu5 1Department of Cardiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania; 2Department of Cardiology, Clinical Rehabilitation Hospital, Cluj-Napoca, 400347, Romania; 3Department of Medical Biochemistry, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania; 4 4th Medical Clinic, Department of Internal Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania; 5Department of Pharmacology, Toxicology and Clinical Pharmacology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, RomaniaCorrespondence: Dana PopDepartment of Cardiology, Clinical Rehabilitation Hospital, 46-50 Viilor Street, Cluj-Napoca, 400347, RomaniaTel +40 744 159 933Fax +40 364 818 027Email pop67dana@gmail.comBackground and Aims: Leptin, one of the best-known adipocytes, together with the renin-angiotensin-aldosterone system and galectin-3 are important players in inflammation, arterial hypertension and heart failure pathophysiology. Moreover, uninucleotide A1166C polymorphism is associated with hypertension and poor prognosis in heart failure. The aim of the study was to investigate a possible relationship between leptin serum values, specific heart failure biomarkers and the presence of AT1 receptor A1166C polymorphism in overweight and obese heart failure patients.Methods: The study included 88 consecutive overweight and obese patients admitted for decompensated heart failure. NT-proBNP, MR-proANP, galectin-3 and leptin levels were determined on the arrival day. Genotyping of the A1166C allele – AT1 receptor gene was performed in all patients in order to find variants.Results: We found a strong positive correlation (r = 0.347, p = 0.001) between leptin serum concentrations and BMI. Leptin levels were not correlated with heart failure biomarkers (NT-proBNP, MR-proANP and galectin-3). All homozygote CC variants were hypertensive, but we registered no significant difference in genetic AC and AA variants distribution between hypertensive and normotensive. Leptin was not significantly modified by the presence of potentially pathogenic A1166C–AT 1 receptor genotypes (AC + CC). But, galectin-3 was found in higher concentrations in patients with heterozygous and homozygous A1166C mutations.Conclusion: Overweight and obese patients with heart failure display high leptin serum levels. Leptin does not offer incremental prognostic value in heart failure overweight and obese patients. But, galectin-3 was found in higher concentrations in patients with heterozygous and homozygous A1166C mutations, suggesting a worse prognosis probably due to more advanced cardiac fibrosis.Keywords: leptin, galectin-3, heart failure, obesity, arterial hypertension, AT1 receptor mutation