Tsaroucha Agori, Daniil Zoe, Malli Foteini, Georgoulias Panagiotis, Minas Markos, Kostikas Konstantinos, Bargiota Alexandra, Zintzaras Elias, Gourgoulianis Konstantinos I
Respiratory Medicine Department, University of Thessaly School of Medicine, University Hospital of Larissa, Larissa, Greece.
J Asthma. 2013 Mar;50(2):188-97. doi: 10.3109/02770903.2012.747101. Epub 2012 Dec 21.
The mechanisms underlying the relationship between obesity and asthma have not been fully established. Data in the literature suggest that adipose tissue-derived hormones may be implicated. However, no definite conclusions regarding the role of leptin and adiponectin with asthma are available. No studies have examined the role of ghrelin in asthma.
We assessed the circulating concentrations of leptin, adiponectin, and ghrelin in 32 postmenopausal stable asthma patients, 37 female asthmatics during exacerbations and 8 weeks later, and 22 controls. We examined the relationship between the three peptides and indexes of pulmonary function, airway inflammation, and atopy.
Stable asthma patients exhibited higher leptin and lower ghrelin concentrations compared with controls. Patients with severe asthma had higher leptin and lower adiponectin levels versus patients with mild to moderate asthma. Both leptin concentrations and leptin/adiponectin ratio served as markers for discriminating asthma patients from controls on the one hand, and severe from mild to moderate asthmatics on the other. Leptin levels were inversely correlated with both FEV(1)/FVC and FEF(25-75) in patients with mild to moderate asthma. Atopic asthma patients had higher leptin concentrations than nonatopic asthma patients. There was a positive correlation between serum leptin and total IgE levels in atopic asthmatics. Finally, serum leptin levels and leptin/adiponectin ratio were significantly increased during asthma exacerbations, while adiponectin and ghrelin levels were significantly decreased.
Our findings suggest that leptin, adiponectin, and ghrelin may play a significant role in the pathogenesis of asthma during both stable state and asthma exacerbation, independent of obesity.
肥胖与哮喘之间关系的潜在机制尚未完全明确。文献数据表明，脂肪组织衍生的激素可能与之相关。然而，关于瘦素和脂联素在哮喘中的作用尚无定论。目前尚无研究探讨胃饥饿素在哮喘中的作用。
我们评估了32例绝经后稳定期哮喘患者、37例女性哮喘急性发作期患者及其发作8周后的患者以及22名对照者体内瘦素、脂联素和胃饥饿素的循环浓度。我们研究了这三种肽与肺功能、气道炎症和特应性指标之间的关系。
与对照组相比，稳定期哮喘患者的瘦素浓度较高，胃饥饿素浓度较低。重度哮喘患者的瘦素水平高于轻度至中度哮喘患者，脂联素水平则较低。瘦素浓度和瘦素/脂联素比值一方面可作为区分哮喘患者与对照者的标志物，另一方面可作为区分重度与轻度至中度哮喘患者的标志物。在轻度至中度哮喘患者中，瘦素水平与FEV(1)/FVC和FEF(25 - 75)均呈负相关。特应性哮喘患者的瘦素浓度高于非特应性哮喘患者。特应性哮喘患者血清瘦素与总IgE水平呈正相关。最后，哮喘急性发作期血清瘦素水平和瘦素/脂联素比值显著升高，而脂联素和胃饥饿素水平显著降低。
我们的研究结果表明，瘦素、脂联素和胃饥饿素可能在哮喘稳定期和急性发作期的发病机制中发挥重要作用，且独立于肥胖因素。
