Decreased Serum Lipoprotein Levels as a Guide for Clinical Severity in Patients with Idiopathic Dilated Cardiomyopathy

• Published in: The Tohoku Journal of Experimental Medicine Vol. 206; no. 3; pp. 219 - 224
• Main Authors: Sezgin, Nurzen, Sezgin, Alpay T., Gullu, Hakan, Karabulut, Aysun, Barutcu, Irfan, Topal, Ergun, Yalcintas, Defne, Temel, Ismail
• Format: Journal Article
• Language: English
• Published: Japan Tohoku University Medical Press 01.07.2005
• Subjects: Adult; Aged; apolipoprotein; Apolipoprotein A-I - metabolism; Apolipoproteins - metabolism; Cardiomyopathy, Dilated - blood; Cardiomyopathy, Dilated - diagnosis; Cholesterol - metabolism; Cholesterol, HDL - metabolism; Cholesterol, LDL - metabolism; cytokine; Cytokines - metabolism; Echocardiography; Female; Glucose - metabolism; heart failure; Humans; Interleukin-6 - metabolism; lipoprotein; Lipoproteins - blood; Lipoproteins - metabolism; Male; Middle Aged; Prognosis; Prospective Studies; Risk Factors; Tumor Necrosis Factor-alpha - metabolism
• ISSN: 0040-8727; 1349-3329
• DOI: 10.1620/tjem.206.219

Hyperlipidemia is a cardiovascular risk factor. In patients with idiopathic dilated cardiomyopathy (IDC), prognostic roles of endogenous lipoproteins are not fully clarified. It has been known that there is a direct relationship between the levels of cytokines (tumor necrosis factor-α [TNF-α] and interleukin-6 [IL-6]) and deteriorating functional classes of heart failure and mortality. The present study compared the levels of circulating TNF-α, IL-6, lipoproteins, and apolipoproteins in patients with stable IDC (n = 28) with those of patients with unstable IDC (n = 26) and controls (n = 24). Mean serum total cholesterol (TC) was significantly lower in stable IDC patients than controls (p < 0.05). In unstable IDC patients, mean serum TC was also lower than controls but not statistically significant. The IDC patients had significantly higher concentrations of IL-6 and TNF-α than the controls (p < 0.01). Serum IL-6 and Apo AI levels were significantly different between stable and unstable IDC patients (p = 0.021 and p = 0.012, respectively). Increased levels of IL-6 were associated with decreased levels of TC (r = −0.266, p = 0.019), LDL-C (r = −0.376, p = 0.001) and apolipoprotein AI (apo AI) (r = −0.495, p < 0.001) in all IDC patients. TNF-α was also inversely related to apo AI (r = −0.455, p < 0.001) and LDL-C (r = −0.364, p = 0.001) in all patients. Thus, elevated serum levels of cytokines in patients with IDC are associated with decreased lipoprotein concentrations, which may indicate impaired prognosis.