Association of adiponectin with bone mineral density in patients with chronic heart failure

Objective:To investigate the association of serum adiponectin with bone mineral density in patients with chronic heart failure(CHF). Method:Eighty-nine patients with chronic heart failure were recruited.The bone mineral density(BMD) of the lumbar spine(L2-L4),the total hip,and the left femoral neck was detected by dual energy X-ray absorptiometry(DXA).Serum adiponectin level was determined by enzyme-linked immunosorbentassay(ELISA) and other biochemical indicators were measured.All of patients were divided in different groups according to NYHA and the levels of BMD. Result:Compared with healthy control group,the BMD of the lumbar spine(L2-L4),the total hip and the left femoral neck was significantly lower in patients with CHF(P0.01).Furthermore,the BMD of all of the site increased with augmentation of grade of the NYHA class.However,there was no significant difference in the Ⅲ and Ⅳ grade of the NYHA class(P0.05).The levels of adiponectin were significantly higher in patients than in healthy controls(P0.01).Higher level of adiponectin was also shown to be associated with more severe form of heart failure.However,there were not significantly difference in the Ⅲ and Ⅳ grade of the NYHA class(P0.05).The levels of adiponectin in CHF patients with osteopotosis were significantly increased(P0.01).Serum adiponectin levels were negatively related to BMD at the lumbar spine,the total hip,and the left femoral neck(r=-0.463,r=-0.423,r=-0.332,P0.01 respectively).In stepwise multiple linear regression model,after adjustion with other factors(including gender,age,soma index,systolic pressure,diastolic pressure,blood glucose,blood lipid,left ventricular ejection fraction,creatinine,uric acid,adiponection and so on),Serum adiponectin levels were negatively correlated with the BMD of the lumbar spine,the total hip,and the left femoral neck(β=-2.287,-2.163,-1.872,P0.01). Conclusion:Adiponectin is an independent predictor of BMD in patients with CHF.Adiponectin,as cardioprotective hormone,may exert negative effect on bone mass in patients with CHF.