Purpose. Adiponectin, a 247 aminoacid protein produced mainly by adipose tissue, beside its effects on glucose metabolism, plays important protective function against cardiovascular disease. Adiponectin is inversely correlated with an increased cardiovascular risk and hypo-adiponectinemia is considered an independent cardiovascular risk factor. On the contrary, the role of adiponectin in heart failure (HF) is not fully known. In order to evaluate the prognostic value of circulating adiponectin, we measured total adiponectin plasma levels in patients with HF of different severity. Methods. Total adiponectin, leptin and interleukin(IL)-6 levels were measured in plasma samples of 159 no diabetic patients with different etiology HF (17 in NYHA class I, 82 in NYHA class II, 46 in NYHA class III and 14 in NYHA class IV, age 62?14 yrs, LEVF% 32.5?0.79, mean?sem) and in 31 healthy subjects as control, by dedicated ELISA (Linco Res-US, DRG Diagnostics-Germany, Diaclone Research-France, respectively). In the same group brain natriuretic peptide (BNP) levels were determined by IRMA (Shionogi, Osaka, Japan). Results. Our findings indicated that total adiponectin levels increased significantly as a function of disease severity (7.1?0.61 mg/ml vs 10.9?1.4 in NYHA class I vs 12.8?0.95 in NYHA class II vs 15.7?1.3 in NYHA III vs 16.7?1.8 in NYHA class IV; p<0.001 NYHA II, III and IV vs controls) and they correlated negatively with LVEF% (p=0.0009), positively with cardiac function (BNP levels) (p<0.0001) and inflammation (IL-6 levels) (p<0.0001). We did not observe any correlation with metabolism (BMI) in patients with HF, while a significant correlation was found between leptin and BMI (p<0.0001). Conclusion. Circulating adiponectin is associated with cardiovascular function and inflammation in HF patients. The increased adiponectin plasma levels in HF is a marker of disease severity, indipendent of metabolism
