Reciprocal effects of systemic inflammation and brain natriuretic peptide on adiponectin biosynthesis in adipose tissue of patients with ischemic heart disease

Arterioscler Thromb Vasc Biol. 2014 Sep;34(9):2151-9. doi: 10.1161/ATVBAHA.114.303828. Epub 2014 Jul 24.


Objective: To explore the role of systemic inflammation in the regulation of adiponectin levels in patients with ischemic heart disease.

Approach and results: In a cross-sectional study of 575 subjects, serum adiponectin was compared between healthy subjects, patients with coronary artery disease with no/mild/severe heart failure (HF), and patients with nonischemic HF. Adiponectin expression and release from femoral, subcutaneous and thoracic adipose tissue was determined in 258 additional patients with coronary artery bypass grafting. Responsiveness of the various human adipose tissue depots to interleukin-6, tumor necrosis factor-α, and brain natriuretic peptide (BNP) was examined by using ex vivo models of human fat. The effects of inducible low-grade inflammation were tested by using the model of Salmonella typhi vaccine-induced inflammation in healthy individuals. In the cross-sectional study, HF strikingly increased adiponectin levels. Plasma BNP was the strongest predictor of circulating adiponectin and its release from all adipose tissue depots in patients with coronary artery bypass grafting, even in the absence of HF. Femoral AT was the depot with the least macrophages infiltration and the largest adipocyte cell size and the only responsive to systemic and ex vivo proinflammatory stimulation (effect reversible by BNP). Low-grade inflammation reduced circulating adiponectin levels, while circulating BNP remained unchanged.

Conclusions: This study demonstrates the regional variability in the responsiveness of human adipose tissue to systemic inflammation and suggests that BNP (not systemic inflammation) is the main driver of circulating adiponectin in patients with advanced atherosclerosis even in the absence of HF. Any interpretation of circulating adiponectin as a biomarker should take into account the underlying disease state, background inflammation, and BNP levels.

Keywords: adiponectin; adipose tissue; heart failure; inflammation; natriuretic peptide, brain.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiponectin / biosynthesis*
  • Adiponectin / genetics
  • Adipose Tissue / metabolism*
  • Aged
  • Brachial Artery / diagnostic imaging
  • Brachial Artery / physiopathology
  • Coronary Artery Bypass
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / metabolism
  • Cross-Sectional Studies
  • Female
  • Heart Failure / etiology
  • Heart Failure / metabolism*
  • Humans
  • Inflammation / metabolism*
  • Interleukin-6 / blood
  • Interleukin-6 / pharmacology
  • Male
  • Middle Aged
  • Myocardial Ischemia / complications
  • Myocardial Ischemia / metabolism*
  • Natriuretic Peptide, Brain / blood
  • Natriuretic Peptide, Brain / physiology*
  • Organ Culture Techniques
  • Organ Specificity
  • Risk Factors
  • Subcutaneous Fat
  • Thigh
  • Thorax
  • Tumor Necrosis Factor-alpha / pharmacology
  • Ultrasonography
  • Vasodilation
  • Ventricular Dysfunction, Left / etiology
  • Ventricular Dysfunction, Left / physiopathology


  • ADIPOQ protein, human
  • Adiponectin
  • IL6 protein, human
  • Interleukin-6
  • Tumor Necrosis Factor-alpha
  • Natriuretic Peptide, Brain