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. 2022 Apr 26:2022:9908450.
doi: 10.1155/2022/9908450. eCollection 2022.

Discriminatory Value of Adiponectin to Leptin Ratio for COVID-19 Pneumonia

Federica Tonon  1 , Stefano Di Bella  1   2 , Fabiola Giudici  3 , Verena Zerbato  2 , Ludovica Segat  4 , Raffaella Koncan  1 , Andrea Misin  2 , Barbara Toffoli  1 , Pierlanfranco D'Agaro  1   4 , Roberto Luzzati  1   2 , Bruno Fabris  1   5 , Stella Bernardi  1   5
Affiliations

Discriminatory Value of Adiponectin to Leptin Ratio for COVID-19 Pneumonia

Federica Tonon et al. Int J Endocrinol. .

Abstract

Purpose: Obesity is a risk factor for severe coronavirus disease 2019 (COVID-19). Circulating adipokines have been associated with inflammatory burden and amplified or dysregulated immune responses. This study aimed to evaluate the discriminatory ability of adipokines to identify COVID-19 pneumonia and to assess disease severity.

Methods: We conducted an observational case-control study, with a prospective design, and recruited patients with diagnosis of COVID-19 pneumonia (n = 48) and healthy controls (n = 36), who were matched by age, sex, and BMI. Leptin, adiponectin, IL-6, and TNF-α were measured by ELISA.

Results: Patients with COVID-19 pneumonia had higher levels of leptin, lower adiponectin/leptin (Adpn/Lep) ratio, and higher expression of IL-6. Leptin had an acceptable discriminatory accuracy for COVID-19 pneumonia in patients with BMI >30 (AUC 0.74 [0.58, 0.90]) with a cutoff of 7852 pg/mL and it was associated with maximum respiratory support. By contrast, Adpn/Lep had an excellent discriminatory accuracy for COVID-19 pneumonia in patients with BMI <25 (AUC 0.9 [0.74, 1.06]) with a cutoff of 2.23.

Conclusion: Our data indicate that high Adpn/Lep (>2.23) in lean patients is consistent with a state of good health, which decreases in case of inflammatory states, ranging from adipose tissue dysfunction with low-grade inflammation to COVID-19 pneumonia.

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Conflict of interest statement

The authors declare that there are no conflicts of interest regarding the publication of this article.

Figures

Figure 1
Figure 1
Leptin, adiponectin, Adpn/Lep levels, IL-6, and TNF-α in patients with COVID-19 pneumonia (COVID-19) and healthy controls (CNT). (a) Leptin, Mann–Whitney test. (b-c) Leptin after BMI and sex stratification, Mann–Whitney test or unpaired t-test. (d) Adiponectin, t-test. (e-f) Adiponectin after BMI and sex stratification, t-test. (g) Adpn/Lep, Mann–Whitney test. (h-i) Adpn/Lep after BMI and sex stratification, Mann–Whitney test. (j) Percentage of patients with detectable levels of IL-6 and TNF-α, chi-square test. (k) IL-6, Mann–Whitney test. (l) TNF-g, Mann–Whitney test. (m) IL-6 after sex stratification, Mann–Whitney test.
Figure 2
Figure 2
Discriminatory value of Adpn/Lep for COVID-19 pneumonia. Adpn/Lep receiver operator characteristic curves illustrating the ability of Adpn/Lep to identify COVID-19 pneumonia after BMI stratification.
Figure 3
Figure 3
Factors associated with maximum respiratory support given. Mann–Whitney test or t-test (a–g), (i), and chi-square test (h, j).
See this image and copyright information in PMC

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