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. 2020 Jul 30;20(1):204.
doi: 10.1186/s12890-020-01233-4.

High plasma adiponectin is associated with increased pulmonary blood flow and reduced right ventricular function in patients with pulmonary hypertension

Dongling Luo  1 , Pengyuan Chen  2 , Ziyang Yang  1 , Yongheng Fu  3 , Yigao Huang  1 , Hezhi Li  4 , Jimei Chen  5 , Jian Zhuang  6 , Caojin Zhang  7
Affiliations

High plasma adiponectin is associated with increased pulmonary blood flow and reduced right ventricular function in patients with pulmonary hypertension

Dongling Luo et al. BMC Pulm Med. .

Abstract

Background: Adiponectin is a biomarker closely related to heart failure. However, its role in pulmonary hypertension remains unclear. In this study, we investigated the association between adiponectin and hemodynamic abnormalities, right ventricular function in patients with congenital heart disease associated pulmonary hypertension (CHD-PH).

Methods: Patients with CHD-PH were enrolled in this cross-sectional study. Linear regression analysis was performed to assess the association between adiponectin, N-terminal pro-Brain Natriuretic Peptide (NT-proBNP) and different clinical parameters. Results were depicted as beta-estimates(ß) with 95%-confidence intervals (95% CI). In addition, mediation and receiver operating characteristic curve analyses were used to analyze the relationships among adiponectin, NT-proBNP and right ventricular function.

Results: A total of 86 CHD-PH patients were included. The overall mean adiponectin concentration was 7.9 ± 5.8 μg/ml. Log adiponectin was positively correlated with pulmonary circulation index (ß = 2.2, 95% CI 0.5, 4.0), log NT-proBNP (ß = 0.22, 95% CI 0.04, 0.41) and inversely with the tricuspid annular plane systolic excursion (TAPSE, ß = -4.7, 95% CI -8.6, - 0.8). The mediation analysis revealed the association between NT-proBNP and TAPSE was fully mediated by adiponectin (total effect c = - 5.4, 95% CI -9.4, - 1.5, p = 0.013; direct effect c' = - 3.7, 95% CI -7.5, 0.1, p = 0.067). Additionally, the efficiency of adiponectin for detecting right ventricular dysfunction was not inferior to NT-proBNP (AUC = 0.84, 95% CI 0.67-1.00 vs AUC = 0.74, 95% CI 0.51-0.97, p = 0.23).

Conclusions: Adiponectin is closely correlated with pulmonary blood flow and right ventricular function and may be a valuable biomarker for disease assessment in patients with pulmonary hypertension.

Keywords: Adiponectin; Congenital heart disease; N-terminal pro-brain natriuretic peptide; Pulmonary hypertension; Right ventricular function.

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Conflict of interest statement

All authors declared no conflicts of interest (including financial, political, personal, religious, ideological, academic, intellectual, commercial or any other) in relation to this manuscript.

Figures

Fig. 1
Fig. 1
Correlation between log adiponectin and log NT-proBNP. Log adiponectin is positively correlated with log NT-proBNP (r = 0.41, p = 0.0004). Log adiponectin and log NT-proBNP are log 10 scale transformation of plasma levels of adiponectin and NT-proBNP
Fig. 2
Fig. 2
The mediation effect of adiponectin (APN) on the association between NT-proBNP and right ventricular dysfunction. a is the coefficient between log NT-ProBNP and log adiponectin (a = 0.22, 95%CI 0.04, 0.41, p = 0.023). b is the coefficient between log adiponectin and TAPSE (b = − 6.2, 95%CI -11.0, − 1.4, p = 0.02). c is the coefficient between log NT-proBNP and TAPSE (c = − 5.4, 95%CI -9.4, − 1.5, p = 0.013). The coefficient c’ between log NT-proBNP and TAPSE becomes insignificant when log adiponectin is included in the model (c’ = − 3.7, 95%CI -7.5, 0.1, p = 0.067). These results reveal that the association between NT-proBNP and right ventricular dysfunction, as assessed by TAPSE, is fully mediated by APN. TAPSE, tricuspid annular plane systolic excursion
Fig. 3
Fig. 3
Receiver operating characteristic curve of adiponectin and NT-proBNP. There’s a trend that adiponectin exhibited a better diagnostic efficiency as compared to NT-proBNP in patients with right ventricular dysfunction (AUC = 0.84, 95%CI 0.67–1.00; AUC = 0.74, 95%CI 0.51–0.97, respectively, p = 0.23). AUC, area under the curve
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