Bolton C E, Evans M, Ionescu A A, Edwards S M, Morris R H K, Dunseath G, Luzio S D, Owens D R, Shale D J
Department of Respiratory Medicine, School of Medicine, Cardiff University, Llandough Hospital, Vale of Glamorgan, UK.
COPD. 2007 Jun;4(2):121-6. doi: 10.1080/15412550701341053.
Chronic obstructive pulmonary disease (COPD) is associated with a continuous systemic inflammatory response. Furthermore, COPD is associated with an excess risk for cardiovascular disease and type II diabetes. Systemic inflammation in other populations is a factor in atherogenesis and has been associated with insulin resistance. We assessed the association between systemic inflammation and insulin resistance in non-hypoxaemic patients with COPD. Fasting plasma glucose, insulin and inflammatory mediators were measured in 56 patients and 29 healthy subjects. Body mass index (BMI) and height squared fat- and fat-free-mass index were similar between subject groups. Using homeostatic modelling techniques, mean (SD) insulin resistance was greater in the patients, 1.68 (2.58) and 1.13 (2.02) in healthy subjects, p=0.032. Fasting plasma insulin was increased in patients while glucose was similar to that in healthy subjects. Patients had increased circulating inflammatory mediators. Insulin resistance was related to interleukin-6 (IL-6), r=0.276, p=0.039, and tumour necrosis factor alpha soluble receptor I, r=0.351, p=0.008. Both IL-6 and BMI were predictive variables of insulin resistance r(2)=0.288, p<0.05. We demonstrated greater insulin resistance in non-hypoxaemic patients with COPD compared with healthy subjects, which was related to systemic inflammation. This relationship may indicate a contributory factor in the excess risk of cardiovascular disease and type II diabetes in COPD.
慢性阻塞性肺疾病（COPD）与持续的全身炎症反应相关。此外，COPD与心血管疾病和II型糖尿病的额外风险相关。其他人群中的全身炎症是动脉粥样硬化的一个因素，并且与胰岛素抵抗有关。我们评估了非低氧血症COPD患者全身炎症与胰岛素抵抗之间的关联。对56例患者和29名健康受试者测量了空腹血糖、胰岛素和炎症介质。受试者组之间的体重指数（BMI）以及身高平方脂肪和去脂体重指数相似。使用稳态建模技术，患者的平均（标准差）胰岛素抵抗更高，患者为1.68（2.58），健康受试者为1.13（2.02），p = 0.032。患者的空腹血浆胰岛素升高，而血糖与健康受试者相似。患者的循环炎症介质增加。胰岛素抵抗与白细胞介素-6（IL-6）相关，r = 0.276，p = 0.039，与肿瘤坏死因子α可溶性受体I相关，r = 0.351，p = 0.008。IL-6和BMI都是胰岛素抵抗的预测变量，r² = 0.288，p < 0.05。我们证明，与健康受试者相比，非低氧血症COPD患者存在更大的胰岛素抵抗，这与全身炎症有关。这种关系可能表明COPD中心血管疾病和II型糖尿病额外风险的一个促成因素。
