Abstract:

 Objective   To investigate the association of adipokine′s levels with left systolic and diastolic function in patients with metabolic syndrome (MS). Methods   We enrolled 48 patients with MS and 49 gender-and age-matched healthy subjects who served as the control. Tissue Doppler imaging echocardiography was performed to measure systolic and diastolic mitral annular velocities, including the peak systolic mitral annulus velocity (Sm), the peak early diastolic mitral annulus velocity (Em) and the peak late diastolic mitral annulus velocity (Am). Real-time PCR assays were applied to detect expressions of leptin receptor and ghrelin mRNA expressions in peripheral blood mononuclear cells(PBMCs). Results   Compared with the control, the MS group showed significant increases in the peak late diastolic velocity (A) but decreases in the ratio of early and late diastolic peak velocity (E/A), Sm, Em, and the ratio of Em and Am (Em/Am) (P<0.01～0.001). mRNA expressions of leptin receptor and ghrelin were significantly decreased in the MS group (all P<0.05). Expression of leptin receptor mRNA level was significantly correlated with A, E/A, Sm, Em and Em/Am (P<0.05～0.001), while the ghrelin mRNA level showed a significantly positive correlation with Em and Sm (P<0.05～0.01). Stepwise multiple linear regression analysis revealed a significant and independent association of E/A with decreases of leptin receptor mRNA level, as was the association of Sm with the decreases of ghrelin mRNA level.  Decreases of leptin receptor mRNA level in PBMCs was an independent risk factor for left ventricular diastolic dysfunction，and the reduction of ghrelin mRNA expression was an independent risk factor for the early impairment of left ventricular systolic function. Conclusion   The reduction of leptin receptor and ghrelin mRNA expression may contribute to impairments of left function in patients with metabolic syndrome.

Key words: Metabolic syndrome; Cardiac; Systolic function; Diastolic function; Adipokines