Leptin serum levels in cachectic heart failure patients - Relationship with tumor necrosis factor-alpha system

Cachexia is a strong predictor for mortality in patients with congestive he art failure. To investigate the role of leptin and regulators of apoptosis in cardiac cachexia we compared leptin concentrations and their relation to the TNF system, interleukin 1-beta (TL-1b), and soluble Fas in patients wi th heart failure with and without cachexia. Patients with cardiac cachexia have increased levels of interleukin-1b compared to non-cachectic heart fai lure patients [mean(S.E.)=1.11(0.62) vs. 0.02(0.02), P=0.01] and decreased concentrations of leptin [10.79(3.93) vs. 23.24 (8.35), P=0.1]. Leptin leve ls correlate with TNF-RI in cachectic heart failure patients (r=0.58, P=0.0 18). The TNF-RI levels were also correlated with Fas, both in all the patie nts taken together (r=0.5, P=0.006) and in those with cachexia (r=0.52, P=0 .036). Our data indicate that more prospective studies are needed to clarif y the role of leptin in the pathophysiology of heart failure cachexia. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.