Dysregulation of insulin levels in Chagas heart disease is associated with altered adipocytokine levels

• Published in: Canadian journal of physiology and pharmacology Vol. 97; no. 2; pp. 140 - 145
• Main Authors: Dabarian, André Luiz, Mady, Charles, Barbosa-Ferreira, João Marcos, Ianni, Barbara Maria, Hotta, Viviane Tiemi, Ramires, Félix José Alvarez, Lopes, Heno Ferreira, Buck, Paula de Cássia, Pessoa, Fernanda Gallinaro, Fonseca, Keila Cardoso Barbosa, Nogueira, Adriana Ramos, Fernandes, Fábio
• Format: Journal Article
• Language: English
• Published: Canada NRC Research Press 01.02.2019; Canadian Science Publishing NRC Research Press
• Subjects: adipocytokine; Adiponectin; Autonomic nervous system; Cardiac patients; Cardiomyopathy; Cardiovascular diseases; Chagas disease; Chagas heart disease; Cholesterol; Congestive cardiomyopathy; Congestive heart failure; Coronary artery disease; Cytokines; Diabetes therapy; Dilated cardiomyopathy; Etiology; Etiology (Medicine); Glucose; Heart; Heart diseases; Heart failure; Heart rate; Inflammation; Insulin; insulin levels; Interleukin 6; Interleukins; Leptin; maladie cardiaque de Chagas; Metabolism; Myocardial diseases; Necrosis; Patient monitoring equipment; Pharmacology; Physiological aspects; Physiology; taux d’insuline; Tumor necrosis factor; Tumor necrosis factor-α; Tumors; Vector-borne diseases; Ventricle
• ISSN: 0008-4212; 1205-7541
• DOI: 10.1139/cjpp-2018-0349

Metabolic, inflammatory, and autonomic nervous system (ANS) dysfunction are present in patients with heart failure. However, whether these changes are due to left ventricular dysfunction or heart failure etiology is unknown. We evaluated metabolism and inflammatory activity in patients with idiopathic dilated cardiomyopathy (IDC) and Chagas cardiomyopathy (CHG) and their correlation with the ANS. Forty-six patients were divided into 3 groups: IDC, CHG, and control. We evaluated adiponectin, leptin, insulin, interleukin-6, and tumor necrosis factor-alpha. ANS were analyzed by heart rate variability in time and frequency domains on a 24-hour Holter monitor. Levels of glucose, cholesterol, leptin, and adiponectin did not show differences between groups. Insulin levels were lower in CHG group (5.4 ± 3.3 μU/mL) when compared with control (8.0 ± 4.9 μU/mL) and IDC (9.9 ± 5.0 μU/mL) groups (p = 0.007). Insulin was positively associated with LFr/HFr ratio (r = 0.562; p = 0.029) and with the LFr component (r = 0.562; p = 0.029) and negatively associated with adiponectin (r = –0.603; p = 0.017) in CHG group. The addition of an adiponectin unit reduced average insulin by 0.332 μg/mL. Insulin levels were decreased in the CHG group when compared with the IDC group and were associated with ANS indexes and adiponectin levels.