Department of Chest Disease, Mersin University Faculty of Medicine, Mersin, Turkey.
Scand J Clin Lab Invest. 2010 Feb;70(1):40-4. doi: 10.3109/00365510903484063.
The aim of the study was to compare endocrine parameters such as leptin, visfatin, insulin resistance, exercise capacity and body composition change, the pulmonary functions test (PFT) and arterial blood gases (ABG) parameters of chronic obstructive pulmonary disease (COPD) patients and in healthy controls.
Fifty-five patients with COPD and without malnutrition and 25 healthy controls were included in our study. The serum leptin, visfatin, tumor necrosis factor alpha (TNF-alpha) and insulin resistance, body fat-free mass (FFM) and fat mass (FM) were measured in the groups. Additionally, body mass index (BMI) was calculated and the 6-minute walk test (6MWT), PFT and ABG analyses were performed in all of the cases.
No difference in BMI between the COPD group and controls was determined. Serum leptin and visfatin levels, FFM and 6MWT distance were significantly lower in the patients with COPD (p < 0.001, p = 0.001, p = 0.032, p < 0.001, respectively). A correlation was found between serum leptin levels and BMI (r = 0.333, p = 0.027), and with FM (r = 0.365, p = 0.029). Serum visfatin level was correlated with the percentage of forced expiratory volume in the first second in the patients with COPD (r = 0.371, p = 0.013). HOMA-IR (Homeostasis model assessment of insulin resistance) and serum TNF-alpha levels in the patients with COPD were found to be significantly higher than controls (p = 0.001, p < 0.001).
These results may be earlier signs for further diseases that can emerge in the advanced stages in patients with COPD. Evaluating the patients not only with the pulmonary function and also systemically, contributes to minimizing the mortality and morbidity.
本研究旨在比较慢性阻塞性肺疾病（COPD）患者和健康对照组的内分泌参数（如瘦素、内脏脂肪素、胰岛素抵抗、运动能力和身体成分变化）、肺功能测试（PFT）和动脉血气（ABG）参数。
本研究纳入了 55 名无营养不良的 COPD 患者和 25 名健康对照者。测量了两组患者的血清瘦素、内脏脂肪素、肿瘤坏死因子-α（TNF-α）和胰岛素抵抗、去脂体重（FFM）和脂肪量（FM）。此外，所有患者均进行了体重指数（BMI）计算和 6 分钟步行试验（6MWT）、PFT 和 ABG 分析。
COPD 组和对照组的 BMI 无差异。COPD 患者的血清瘦素和内脏脂肪素水平、FFM 和 6MWT 距离显著降低（p<0.001、p=0.001、p=0.032、p<0.001）。血清瘦素水平与 BMI 呈正相关（r=0.333，p=0.027），与 FM 呈正相关（r=0.365，p=0.029）。COPD 患者的血清内脏脂肪素水平与第一秒用力呼气量百分比呈正相关（r=0.371，p=0.013）。COPD 患者的 HOMA-IR（胰岛素抵抗稳态模型评估）和血清 TNF-α水平明显高于对照组（p=0.001、p<0.001）。
这些结果可能是 COPD 患者在晚期出现进一步疾病的早期迹象。不仅要评估患者的肺功能，还要进行系统性评估，有助于降低死亡率和发病率。
