慢性阻塞性肺疾病患者体重指数的决定因素

Determinants of BMI in patients with COPD.

作者信息

Karadag Fisun, Karul Aslihan B, Cildag Orhan, Altun Cagatay, Gurgey Ozgur

机构信息

Chest Diseases, School of Medidcine, Adnan Menderes University, Aydin, Turkey.

出版信息

Respirology. 2004 Mar;9(1):70-5. doi: 10.1111/j.1440-1843.2003.00533.x.

DOI:10.1111/j.1440-1843.2003.00533.x

PMID:14982605

Abstract

OBJECTIVE

COPD is characterized by significant chronic inflammation that is evident not only in the pulmonary compartment but also in the circulation. Peripheral blood features of COPD include markers of oxidative stress and altered circulating levels of inflammatory mediators and acute-phase proteins. The presence of a systemic inflammatory response may influence quality of life by giving rise to weight loss, muscle wasting and tissue depletion. The aim of the present study was to evaluate the determinants of body mass and the value of serum tumour necrosis factor alpha (TNF-alpha) as a marker of weight loss in COPD patients, and to correlate this with the burden of oxidative stress as measured by serum malonyldialdehyde (MDA) levels.

METHODOLOGY

Fifty-two male COPD patients (mean age 62.55 +/- 6.81 years) were studied. After anthropometric measurements and standard spirometry, serum TNF-alpha concentration was measured by enzyme-linked immunosorbent assay using an hTNF-alpha kit, and MDA was studied spectrophotometrically using the Yoshioka-Kawada method.

RESULTS

The mean BMI was 24.82 +/- 3.46. BMI was lower than normal (< 19) in six patients. Mean serum TNF-alpha concentration was 14.99 +/- 8.98 pg/mL and MDA was 0.93 +/- 0.13 nmol/L. There was no significant correlation between serum MDA and TNF concentrations (P = 0.140). Serum TNF-alpha and MDA concentrations were not correlated with severity of airflow obstruction or degree of hypoxaemia (P > 0.05 for all). BMI was negatively correlated with burden of smoking (pack-years) (r = -0.392, P= 0.004); but not with pulmonary function, degree of hypoxaemia, serum TNF-alpha or MDA levels. BMI was significantly lower in current smokers than ex-smokers (P = 0.041); however, serum MDA and TNF levels were similar in both groups.

CONCLUSION

The results of this study indicate that body mass is related to smoking status (both pack-years and continuance of smoking) in COPD; however, serum TNF-alpha concentration does not seem to be a good marker of weight loss in these patients.

摘要

目的

慢性阻塞性肺疾病（COPD）的特征是存在显著的慢性炎症，这不仅在肺部明显，在循环系统中也很显著。COPD的外周血特征包括氧化应激标志物以及炎症介质和急性期蛋白循环水平的改变。全身炎症反应的存在可能通过导致体重减轻、肌肉萎缩和组织消耗来影响生活质量。本研究的目的是评估COPD患者体重的决定因素以及血清肿瘤坏死因子α（TNF-α）作为体重减轻标志物的价值，并将其与通过血清丙二醛（MDA）水平测量的氧化应激负担相关联。

方法

对52名男性COPD患者（平均年龄62.55±6.81岁）进行了研究。在进行人体测量和标准肺功能测定后，使用hTNF-α试剂盒通过酶联免疫吸附测定法测量血清TNF-α浓度，并使用吉冈-川田法通过分光光度法研究MDA。

结果

平均体重指数（BMI）为24.82±3.46。6名患者的BMI低于正常水平（<19）。血清TNF-α平均浓度为14.99±8.98 pg/mL，MDA为0.93±0.13 nmol/L。血清MDA与TNF浓度之间无显著相关性（P = 0.140）。血清TNF-α和MDA浓度与气流阻塞严重程度或低氧血症程度均无相关性（所有P>0.05）。BMI与吸烟负担（包年数）呈负相关（r = -0.392，P = 0.004）；但与肺功能、低氧血症程度、血清TNF-α或MDA水平无关。当前吸烟者的BMI显著低于既往吸烟者（P = 0.041）；然而，两组的血清MDA和TNF水平相似。