Adipokine status and gene expression of leptin and adiponectin from epicardial and subcutaneous adipose tissue in cardiac surgery patients with mitral valve disease: a cross-sectional study

The level of adipokine gene expression in adipose tissue and the concentration of proand anti-inflammatory adipokines in the blood are potentially promising for predicting the severity of patients with cardiovascular diseases, the dynamics of their inflammatory status and cardiac remodeling. However, the assessment of the adipokine status in the cohort of patients with valvular heart diseases remains poorly studied. Aim: To study the relationship between the severity of epicardial and visceral obesity with the adipokine status and the level of adiponectin and leptin gene expression from epicardial and subcutaneous adipose tissue in patients with indications for surgical correction of mitral valve disease. Material and Methods. The study included 51 patients with acquired mitral valve disease of non-infectious genesis, who had indications for surgical correction. All patients were divided into groups depending on visceral/epicardial obesity, with subsequent assessment of the level of expression of leptin and adiponectin genes in adipose tissue, blood concentrations of leptin, adiponectin, resistin. Results. Patients with visceral obesity have been shown to exhibit higher serum levels of the pro-inflammatory adipokine leptin and lower levels of the anti-inflammatory adipokine adiponectin compared to individuals without obesity. Blood leptin levels are significantly higher in patients with epicardial obesity compared to those without. The present study found no association between the level of adipokines in the blood serum and the level of expression of adipokine genes in samples of epicardial and subcutaneous adipose tissue. Conclusions. Patients with visceral and epicardial obesity are characterized by adipokine imbalance in the form of increased leptin levels and decreased adiponectin levels in the blood serum. The lack of association between the level of adipokines in the blood serum and the level of adipokine gene expression in samples of epicardial and subcutaneous adipose tissue can be explained by the disrupted relationship between adiponectin and leptin and their receptors in obesity, which leads to resistance of receptors to adipokines and the development of leptin and adiponectin resistance. As a result, despite the increased level of adipokines in the blood serum, the expression of their genes continues, which leads to the lack of association between the expression of adipokine genes and their serum content.