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Leptin, a Novel Predictor of Lung Function in Heart Failure

Justo Sierra-Johnson, MD, MS^*,; Abel Romero-Corral, MD, MS^*; Virend K. Somers, MD, PhD^*; Lyle J. Olson, MD^* and Bruce D. Johnson, PhD^*

^*From the Divisions of Cardiovascular Diseases, Department of Internal Medicine (JSJ, ARC, VKS, LJO, BDJ); and the Division of Biostatistics and Department of Health Sciences Research (KRB), Mayo Clinic and Foundation, Rochester MN, USA From the Atherosclerosis Research Unit, Department of Medicine (JSJ), Karolinska Institutet, Stockholm, Sweden

johnson.bruce{at}mayo.edu

Abstract

Background: Leptin is a protein hormone produced by adipose tissue. Leptin has pro-inflammatory properties and is usually elevated in chronic heart failure. We assessed if serum leptin relates to the loss in lung function in non-cachectic chronic heart failure patients.

Materials and Methods: One-hundred and thirty-five (age 24-79 yrs; 85 men 50 women) consecutively eligible non-Hispanic white subjects with a diagnosis of stable systolic heart failure were recruited prospectively, along with 106 matched controls. Lung function tests ---forced vital capacity (FVC), forced expiratory volume in 1 second (FEV₁) and single-breath diffusing capacity of the lung for carbon monoxide (DLCO) --- were measured by spirometry. Plasma leptin was measured by radioimmunoassay. Multiple linear regression was applied.

Results: The relationships of FEV1, FVC, and DLCO with leptin differed significantly between heart failure and controls after controlling for age, sex, percent body fat and ejection fraction. In heart failure, leptin was as an independent predictor of FVC values (additional R² =0.05, p<0.0001), FEV₁ values (additional R² =0.05, p<0.0001) and DLCO values (additional R² =0.14, p<0.0001). In a final multiple regression model predicting lung function in heart failure, the independent effect of leptin was significant after further adjustments.

Conclusions: The predictive information provided by leptin is additive to that provided by measures of body fat in heart failure patients, especially for DLCO. Leptin may play a role in the impairment of lung function in subjects with heart failure.

Key Words: Leptin • heart failure • lung • body fat