Body composition, appetite-related hormones, adipocytokines, and heart failure in adult patients with congenital heart disease: A preliminary study

Congenit Heart Dis. 2018 Jan;13(1):79-84. doi: 10.1111/chd.12555. Epub 2017 Nov 27.

Abstract

Objectives: To assess body composition and relationships among body composition, appetite-related hormones, adipocytokines, and heart failure (HF) in adult patients with congenital heart disease (CHD).

Patients: This prospective study enrolled 46 consecutive adult patients with CHD and 12 age-matched healthy controls. The patients and control subjects were divided into four groups: 13 patients with Fontan circulation (group A), 16 patients with cyanosis (group B), 17 patients who previously underwent biventricular repair (group C), and 12 age-matched healthy controls.

Design: Body composition was measured using InBody730, and levels of appetite-related hormones (ghrelin and leptin) and adipocytokines (leptin, interleukin-6, and tumor necrosis factor-α) were determined. Relationships of these measurements between severe HF, defined as New York Heart Association functional class III-IV and/or recent repeated unscheduled hospitalizations due to HF, were examined using univariate logistic analysis.

Results: Mean patient age was 32.1 ± 7.4 years. The skeletal muscle mass was significantly decreased in groups A and B compared with that in controls. Interestingly, ghrelin levels in groups A and B were also significantly lower than those in controls. Univariate logistic analysis revealed that ghrelin level, percent body fat, and pulse oximetric oxygen saturation were significantly associated with severe HF.

Conclusions: Patients with Fontan circulation and those with cyanosis might be at a risk of sarcopenia. Despite the decreased skeletal muscle mass and increased body fat, ghrelin levels in these patients were decreased. These changes might have a negative impact on HF in these patients.

Keywords: body fat; congenital heart disease; ghrelin; heart failure; muscle mass.

MeSH terms

  • Adipokines / metabolism*
  • Adult
  • Biomarkers / metabolism
  • Body Composition*
  • Female
  • Ghrelin / metabolism*
  • Heart Defects, Congenital / complications*
  • Heart Defects, Congenital / metabolism
  • Heart Defects, Congenital / physiopathology
  • Heart Failure / complications
  • Heart Failure / metabolism
  • Heart Failure / physiopathology*
  • Humans
  • Male
  • Muscle, Skeletal / metabolism*
  • Prospective Studies
  • Sarcopenia / etiology*
  • Sarcopenia / metabolism

Substances

  • Adipokines
  • Biomarkers
  • Ghrelin