Tumor Necrosis Factor and Steroid Metabolism in Chronic Heart Failure: Possible Relation to Muscle Wasting
Why the study?
Chronic heart failure is associated with muscle wasting potentially related to imbalance between catabolic and anabolic factors, but the relations with TNF and steroid metabolism are unclear.
Population
63 stable chronic heart failure patients and 20 control subjects
Comparison
Chronic heart failure patients vs control subjects
Design
Observational study measuring biochemical markers and exercise testing
Authors
Discussion
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Overview
No immediate clinical implications; hypothesis-generating for immune-endocrine drivers of HF cachexia, needs prospective trials.
Key Points
- To investigate whether clinical severity and muscle wasting in chronic heart failure correlate with catabolic inflammatory factors and altered anabolic-to-catabolic steroid metabolism.
- Studied 63 patients with stable chronic heart failure (mean age 60.4 ± 11.3 years) and 20 control subjects (mean age 52.8 ± 11.4 years).
- Measured body mass index, maximal incremental exercise testing with metabolic gas exchange, and venous concentrations of TNF, sTNFR-1, sTNFR-2, cortisol, and DHEA.
- Circulating sTNFR-1 (128.9 ± 84.5 vs. 63.6 ± 23.3 pg/ml, p < 0.003) and sTNFR-2 (250.1 ± 109.5 vs. 187.9 ± 92.2 pg/ml, p = 0.03) were higher in patients, while DHEA was lower (9.88 ± 6.94 vs. 15.64 ± 8.33 nmol/l, p = 0.004).
- Log cortisol to log DHEA ratio correlated positively with log TNF (r = 0.50, p < 0.001 in patients), and body mass index correlated inversely with TNF (r = -0.43, p < 0.001) and the cortisol/DHEA ratio (r = -0.32, p = 0.01).
- Peak oxygen consumption correlated inversely with both sTNFR-1 (r = -0.51, p < 0.001) and sTNFR-2 (r = -0.39, p < 0.001).
Cite This Study
Anker et al. (1997) studied this question.