血清 ghrelin 和 adiponectin 水平在低体重慢性阻塞性肺疾病患者中升高，但血清 leptin 水平不变。

Serum ghrelin and adiponectin levels are increased but serum leptin level is unchanged in low weight Chronic Obstructive Pulmonary Disease patients.

机构信息

Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul, Turkey.

Istanbul University, Istanbul Faculty of Medicine, Department of Pulmonary Diseases, Istanbul, Turkey.

出版信息

Eur J Intern Med. 2014 Apr;25(4):364-9. doi: 10.1016/j.ejim.2013.02.012. Epub 2013 Mar 21.

DOI:10.1016/j.ejim.2013.02.012

PMID:23523152

Abstract

BACKGROUND

Weight loss and muscle wasting are common features reported in COPD patients and they are all related with systemic inflammation. In this study, the relationship between pulmonary functions and inflammatory and metabolic parameters in low weight COPD patients were investigated.

METHODS

Fifty male COPD patients were grouped according to the Global Initiative for Chronic Obstructive Lung Disease criteria. Group 1: Mild-moderate COPD patients (n=18; with a mean age of 66.4 ± 9.2 yrs; body mass index (BMI):19.7 ± 1.5 kg/m(2)), group 2: Severe-very severe COPD patients (n=32; with a mean age of 65.9 ± 10.0 yrs; BMI:19.3 ± 1.6 kg/m(2)), group 3: Control group composed of healthy nonsmoking males (n=17; with a mean age of 50.2 ± 8.4 yrs; BMI:21.85 ± 1.5 kg/m(2)). Anthropometric parameters, serum levels of adiponectin (ApN), ghrelin, leptin, hsCRP, IL-6, IL-1β, IL-8, TNF-α and pulmonary functions were compared.

RESULTS

Adiponectin concentration was higher in group 1 (43.3 ± 28.6 ng/mL; p<0.05) and group 2 (59.9 ± 31.8 ng/mL; p<0.001) when compared with the control group (23.5 ± 13.6 ng/mL). Ghrelin concentrations were higher in COPD groups (1281.0 ± 1173.7 and 1840.0 ± 403.6 pg/mL; p<0.05) compared to the control subjects (554.0 ± 281.9 pg/mL). When the groups were compared, no significant difference was found for leptin, IL-1β, TNF-α, and IL-8. Interleukin-6 and hsCRP levels were higher in group 1 than in the control group. ApN was negatively correlated with BMI and FEV1. In all groups, FEV1 showed positive correlation with BMI, skinfold thicknesses, insulin and triglyceride; negative correlation with age, pack/years, HDL-Chol and ApN. Increased SHBG with decreased insulin level and HOMA-IR may indicate increased insulin sensitivity in COPD groups.

CONCLUSION

The anti-inflammatory effect of ApN and ghrelin is more evident in severe-very severe COPD patients.

摘要

背景

体重减轻和肌肉减少是 COPD 患者常见的特征，它们都与全身炎症有关。在这项研究中，我们研究了低体重 COPD 患者的肺功能与炎症和代谢参数之间的关系。

方法

根据全球慢性阻塞性肺疾病倡议标准，将 50 名男性 COPD 患者分为三组。第 1 组：轻度至中度 COPD 患者（n=18；平均年龄 66.4 ± 9.2 岁；体重指数（BMI）：19.7 ± 1.5 kg/m(2)）；第 2 组：重度至极重度 COPD 患者（n=32；平均年龄 65.9 ± 10.0 岁；BMI：19.3 ± 1.6 kg/m(2)）；第 3 组：由健康不吸烟男性组成的对照组（n=17；平均年龄 50.2 ± 8.4 岁；BMI：21.85 ± 1.5 kg/m(2)）。比较了体重指数、血清脂联素（ApN）、ghrelin、瘦素、hsCRP、IL-6、IL-1β、IL-8、TNF-α 和肺功能等指标。

结果

与对照组（23.5 ± 13.6 ng/mL）相比，第 1 组（43.3 ± 28.6 ng/mL；p<0.05）和第 2 组（59.9 ± 31.8 ng/mL；p<0.001）的脂联素浓度更高。与对照组（554.0 ± 281.9 pg/mL）相比，COPD 组的 ghrelin 浓度更高（1281.0 ± 1173.7 和 1840.0 ± 403.6 pg/mL；p<0.05）。当比较各组时，瘦素、IL-1β、TNF-α 和 IL-8 没有显著差异。第 1 组的白细胞介素-6 和 hsCRP 水平高于对照组。ApN 与 BMI 和 FEV1 呈负相关。在所有组中，FEV1 与 BMI、皮褶厚度、胰岛素和甘油三酯呈正相关，与年龄、包/年、HDL-Chol 和 ApN 呈负相关。COPD 组中 SHBG 的增加伴随着胰岛素水平的降低和 HOMA-IR，可能表明胰岛素敏感性增加。