Adipokines: A Possible Contribution to Vascular and Bone Remodeling in Idiopathic Pulmonary Arterial Hypertension

• Published in: Calcified tissue international 2017-04, Vol.100 (4), p.325-331
• Main Authors: Kochetkova, Evgenia A., Ugai, Ludmila G., Maistrovskaia, Yuliya V., Nevzorova, Vera A.
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon - methods; Adipokines - metabolism; Adult; Biochemistry; Biomedical and Life Sciences; Bone Density - physiology; Bone Remodeling - physiology; Cell Biology; Comorbidity; Endocrinology; Familial Primary Pulmonary Hypertension - metabolism; Female; Femur Neck - metabolism; Humans; Hypertension; Life Sciences; Lumbar Vertebrae - metabolism; Male; Nicotinamide Phosphoribosyltransferase - metabolism; Original Research; Orthopedics; Osteoporosis; Osteoporosis - metabolism; Vascular Remodeling
• ISSN: 0171-967X; 1432-0827
• DOI: 10.1007/s00223-016-0224-5

Osteoporosis is a major comorbidity of cardio-respiratory diseases, but the mechanistic links between pulmonary arterial hypertension and bone remain elusive. The purpose of the stud was to evaluate serum adipokines and endothelin-1 (ET-1) levels in the patients with idiopathic pulmonary arterial hypertension (IPAH) NYHA class III-IV and to determine its associations with bone mineral density (BMD). Pulmonary and hemodynamic parameters, BMD Z -scores at the lumbar spine (LS) and femoral neck (FN), serum leptin, adiponectin, visfatin and endothelin-1 (ET-1), were evaluated in 32 patients with IPAH NYHA class III-IV and 30 healthy volunteers. Leptin, adiponectin and ET-1 were higher in the patients with IPAH than in healthy subjects. Visfatin level showed a tendency to increase compared to that of healthy subjects ( p  = 0.076). The univariate analysis revealed a positive correlation between BMD Z -scores at both sites and 6-min walk test, and inverse relation with pulmonary vascular resistance (PVR) and mean pulmonary arterial pressure (mPAP). Adiponectin and visfatin showed positive correlations with PVR ( p  = 0.009 and p  = 0.006). Serum adiponectin, visfatin and leptin were inversely associated with Z -scores. After adjusting for BMI and FMI, such associations persisted between visfatin and adiponectin levels and Z -scores at both sites. ET-1 related to mPAP, cardiac index and PVR. Negative correlation was observed between ET-1 and FN BMD ( p  = 0.01). Positive correlations have revealed between ET-1 and adiponectin ( p  = 0.02), visfatin ( p  = 0.004) in IPAH patients. These results provide further evidence that adipokine and endothelial dysregulation may cause not only a decrease in BMD, but also an increase in hemodynamic disorders of IPAH.