Issues of Adipokine Regulation in Idiopathic Pulmonary Arterial Hypertension and Systemic Osteopenia

Purpose: to determine the role of adipokines and vascular remodeling in formation of osteoporosis in idiopathic pulmonary arterial hypertension (IPAH). Materials and methods. Functional and hemodynamic parameters, bone mineral density (BMD) T-score in lumbar spine (LS) and femoral neck (FN), blood serum levels of leptin, adiponectin, visfatin and endothelin-1 were measured in 27 patients with severe IPAH and 30 healthy volunteers. Results. Half of IPAH patients had osteoporosis. Serum levels of leptin, adiponectin, visfatin and endothelin-1 in IPAH group were higher than in healthy volunteers. BMD T-score was directly related to results of 6-minute walk test and inversely related to pulmonary vascular resistance (PVR). Circulating adiponectin and visfatin concentrations correlated with PVR; endothelin-1 concentration was directly related to pulmonary arterial systolic pressure, cardiac index and PVR. Relations between BMD T-score and circulating adiponectin, visfatin, and endothelin-1 were inverse. Positive correlations existed between serum adiponectin, visfatin and endothelin-1 levels. Conclusion. Results of our study confirm the important role of adipokine and endotheline dysregulation in development of hemodynamic disorders in severe IPAH and evidence for their possible involvement in formation of osteopenic syndrome.