Leptin Deficiency Promotes Central Sleep Apnea in Patients With Heart Failure
| Autor: | Lyle J. Olson, Ivan Cundrle, Prachi Singh, Bruce D. Johnson, Virend K. Somers, Christopher G. Scott, Christelle van der Walt |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Leptin
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Central sleep apnea medicine.drug_class Polysomnography Critical Care and Intensive Care Medicine Ambulatory Care Facilities Atrial natriuretic peptide Internal medicine Natriuretic Peptide Brain Natriuretic peptide medicine Humans Aged Original Research Heart Failure Ejection fraction Leptin Deficiency business.industry Middle Aged Brain natriuretic peptide medicine.disease Sleep Apnea Central Logistic Models Endocrinology Case-Control Studies Heart failure Female Cardiology and Cardiovascular Medicine business Atrial Natriuretic Factor |
| Zdroj: | Chest. 145:72-78 |
| ISSN: | 0012-3692 |
| Popis: | Leptin-deficient animals hyperventilate. Leptin expression by adipocytes is attenuated by atrial natriuretic peptide (ANP). Increased circulating natriuretic peptides (NPs) are associated with an increased risk of central sleep apnea (CSA). This study tested whether serum leptin concentration is inversely correlated to NP concentration and decreased in patients with heart failure (HF) and CSA.Subjects with HF (N = 29) were studied by measuring leptin, NPs, CO2 chemosensitivity (Δminute ventilation [V.e]/Δpartial pressure of end-tidal CO2 [Petco2]), and ventilatory efficiency (V.e/CO2 output [V.co2]) and were classified as CSA or no sleep-disordered breathing by polysomnography. CSA was defined as a central apnea-hypopnea index ≥ 15. The Student t test, Mann-Whitney U test, and logistic regression were used for analysis, and data were summarized as mean ± SD; Plt; .05 was considered significant.Subjects with CSA had higher ANP and brain natriuretic peptide (BNP) concentrations (Plt; .05), ΔV.e/ΔPetco2 (2.39 ± 1.03 L/min/mm Hg vs 1.54 ± 0.35 L/min/mm Hg, P = .01), and V.e/V.co2 (43 ± 9 vs 34 ± 7, Plt; .01) and lower leptin concentrations (8 ± 10.7 ng/mL vs 17.1 ± 8.8 ng/mL, Plt; .01). Logistic regression analysis (adjusted for age, sex, and BMI) demonstrated leptin (OR = 0.07; 95% CI, 0.01-0.71; P = .04) and BNP (OR = 4.45; 95% CI, 1.1-17.9; P = .05) to be independently associated with CSA.In patients with HF and CSA, leptin concentration is low and is inversely related to NP concentration. Counterregulatory interactions of leptin and NP may be important in ventilatory control in HF. |
| Databáze: | OpenAIRE |
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