Plasma BNP, rather than systemic inflammation, was the main driver of circulating adiponectin and its release from adipose tissue depots in patients with advanced atherosclerosis.
Cross-Sectional (n=833)
Does systemic inflammation or brain natriuretic peptide regulate adiponectin biosynthesis in adipose tissue of patients with ischemic heart disease?
Brain natriuretic peptide, rather than systemic inflammation, is the primary driver of circulating adiponectin in patients with advanced atherosclerosis, indicating that adiponectin's utility as a biomarker depends on the underlying disease state and BNP levels.
OBJECTIVE: To explore the role of systemic inflammation in the regulation of adiponectin levels in patients with ischemic heart disease. APPROACH AND RESULTS: In a cross-sectional study of 575 subjects, serum adiponectin was compared between healthy subjects, patients with coronary artery disease with no/mild/severe heart failure (HF), and patients with nonischemic HF. Adiponectin expression and release from femoral, subcutaneous and thoracic adipose tissue was determined in 258 additional patients with coronary artery bypass grafting. Responsiveness of the various human adipose tissue depots to interleukin-6, tumor necrosis factor-α, and brain natriuretic peptide (BNP) was examined by using ex vivo models of human fat. The effects of inducible low-grade inflammation were tested by using the model of Salmonella typhi vaccine-induced inflammation in healthy individuals. In the cross-sectional study, HF strikingly increased adiponectin levels. Plasma BNP was the strongest predictor of circulating adiponectin and its release from all adipose tissue depots in patients with coronary artery bypass grafting, even in the absence of HF. Femoral AT was the depot with the least macrophages infiltration and the largest adipocyte cell size and the only responsive to systemic and ex vivo proinflammatory stimulation (effect reversible by BNP). Low-grade inflammation reduced circulating adiponectin levels, while circulating BNP remained unchanged. CONCLUSIONS: This study demonstrates the regional variability in the responsiveness of human adipose tissue to systemic inflammation and suggests that BNP (not systemic inflammation) is the main driver of circulating adiponectin in patients with advanced atherosclerosis even in the absence of HF. Any interpretation of circulating adiponectin as a biomarker should take into account the underlying disease state, background inflammation, and BNP levels.
Antonopoulos et al. (2014) conducted a cross-sectional in Ischemic heart disease (n=833). Systemic inflammation and Brain Natriuretic Peptide (BNP) was evaluated on Circulating adiponectin levels and its release from adipose tissue depots. Plasma BNP, rather than systemic inflammation, was the main driver of circulating adiponectin and its release from adipose tissue depots in patients with advanced atherosclerosis.