Utilidad clínica y valor pronóstico de los niveles de leptina, su receptor soluble y grelina en pacientes con insuficiencia cardiaca en presencia o ausencia de obesidad

Abstract

ObjectivesThis study aimed to provide experimental data that could enhance understanding of the cardiovascular function of 2 hormones, ghrelin and leptin, which are involved in energy homeostasis. Recent data indicate that serum ghrelin is associated with right ventricular cardiovascular indexes and serum leptin and its soluble receptor are associated with resting heart rate. These associations indicate a close interaction between the endocrine and cardiovascular systems in obesity. Therefore, we sought to evaluate these associations and their clinical significance by measuring ghrelin, leptin and leptin soluble receptor levels in both obese and non-obese patients with cardiac insufficiency.MethodsWe measured serum ghrelin, leptin and soluble leptin receptor levels in 87 patients diagnosed with cardiac insufficiency (classified into 2 groups: obese and non-obese, according to body mass index) and 25 lean controls, using commercially available immunoassays. We also investigated the association of serum ghrelin and leptin levels with brain natriuretic peptide (BNP) as a diagnostic cardiac marker, using a statistical analysis.ResultsGhrelin levels were decreased in cardiac insufficiency. Both leptin and its soluble receptor plasma levels were increased and both correlated with BNP. Serum ghrelin levels differed significantly between patients with cardiac insufficiency and controls (P <.05). Statistically significant differences were also found in serum leptin levels between obese patients with cardiac insufficiency and healthy controls (P<.05). However, no relationship was found between ghrelin levels in obese and non-obese patients with cardiac insufficiency.ConclusionsSome of the metabolic and/or hormone differences between obese patients with heart failure and non-obese individuals, such as elevated leptin levels, may be cardioprotective.