Plasma levels of leptin in patients with chronic heart failure

Chronic heart failure [CHF] is a syndrome characterized by energy dysregulation. In this study, plasma levels of leptin, a protein hormone secreted by adipocytcs and involved in energy regulation, were determined in fourty patients with CHF divided into two equal groups; mild CHF patients, with New York Heart Association [NYHA] functional class 2, and severe CHF patients with NYHA functional class 3 or 4. Left ventricular ejection fraction [LVEF] as determined by echocardiography was < 45% in all patients. The study included also 20 healthy subjects matched for age, gender and body mass index, as controls. Plasma leptin levels were determined by radioimmunoassay. showed significant elevation in plasma leptin levels in patients with severe CHF [8.3 +/- 0.5 ng/nil] compared to controls [5.2 +/- 0.4 ng/ ml, p < 0.001] and mild CHF patients [6.8 +/- 0.6 ng / ml, p< 0.05], with a significant difference between mild CHF patients and controls [p < 0.05]. Signifcant negative [r = 0.362, p < 0.05] and positive [r = + 0.376, p < 0.05] correlations were noticed between plasma leptin levels and each of LVEF and NYHA functional class respectively. we found that patients with CHF were hyperleptinenic with significant correlation between plasma leptin levels and severity of the disease. Further studies arc recommended to clarify the significance of these findings, and we wonder whether leptin could be a marker and / or mediator of energy dysregulation in CHF patients

Increased carotid intimal medial thickness in type 2 diabetes: relation to D-dimers

We investigated common carotid artery intimal - medial thickness [CCA-IMT] as an evidence of generalized atherosclerosis and D-dimers plasma concentrations as a measure of fibrinolytic activity, in 30 type 2 diabetic subjects [with no clinical coronary artery disease [CAD] cerebrovascular or peripheral vascular disease] and 15 healthy control subjects. Also the interrelation between CCA-IMT and D-dimers plasma concentrations and their relations with lipid status and blood sugar levels were evaluated. Diabetic subjects had significantly higher CCA-IMT and D-dimers plasma concentrations than control subjects. In diabetic subjects CCA-IMT and D-dimers plasma concentrations were significantly directly correlated with each other [P<0.01] and with FBS. 2 hPPBS, HbA[Ic], duration of diabetes, plasma fibrinogen, serum cholesterol, LDL-C and age of diabetic subjects. Diabetic subjects with better blood sugar control [FBS<140mg/dl] had significantly lower D-dimers plasma concentrations and non significantly less CCA-IMT than those with poor blood sugar control [FBS>140mg/dl]. suggesting that control of hyperglycaemia reduce haemostatic activation significantly. It is concluded that type 2 diabetic subjects without clinical CAD.cerebrovascular or peripheral vascular diseases, have a higher degree of atherosclerosis than normal control. Also this atherosclerosis is associated with enhanced Fibrin deposition and degradation as evidenced by increased D-dimers plasma concentrations. The control of hyperglycaemia and dyslipidemia that accompanies diabetes, possibly reduce or even prevent the progression of intimal medial thickening and will reduce significantly the activation of haemostasis leading to reduction of CAD and stroke risk