Association between plasma leptin and adiponectin levels and diastolic function in the general population

Background: Total and visceral obesity are associated with subclinical diastolic dysfunction (DD) and heart failure. Adipose tissue is an endocrine organ able to secrete adipokines involved in several obesity-associated diseases. We aimed to evaluate the association between leptin and adiponectin levels and diastolic function. Methods and results: Within a population-based study (EPIPorto), 556 individuals were evaluated. DD was assessed by echocardiography, using tissue Doppler analysis (early diastolic E' velocity and E/E', the ratio between E wave velocity of transmitral flow and E' velocity), according to consensus recommendations. Patients with DD had significantly higher leptin, but similar adiponectin levels. Patients in the highest leptin tertile had lower E' velocity and an increased E/E' ratio (p < 0.01). The association between leptin and DD was sex-specific. After multivariate adjustment, women in the highest leptin tertile had an increased risk of DD (adjusted odds ratio: 3.06; 95% CI: 1.44 - 6.49). Adiponectin levels were not significantly associated with increased risk of DD in both men and women. Conclusions: Higher leptin levels were independently associated with DD, especially in women. Secretion of leptin can be involved in the association between obesity, DD and heart failure risk. Future studies will determine if the inhibition of leptin can improve diastolic function.