Cirić Zorica, Stanković Ivana, Pejčić Tatjana, Ristić Lidija, Rančić Milan, Radović Milan, Nastasijević-Borovec Desa
University of Nis, School of Medicine, Clinic for Lung Diseases "Knez Selo", Clinical Centre of Niš, Niš, Serbia.
Med Glas (Zenica). 2013 Aug;10(2):266-71.
To detect nutrition disorders (underweight and obesity) in patients with chronic obstructive disease (COPD) and presence of systemic inflammation by determination of inflammatory mediators serum values C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α) and leptin.
The examination involved 85 patients with COPD. Nutrition categories were defined by body mass index (BMI). Fat free mass (FFM) was evaluated by mid upper-arm circumference (MUAC) and fat mass (FM) by tricipital skin-fold thickness (TFS). Values of TNF-α and leptin were measured by standardized ELISA kits and, CRP by latex turbidimetry.
There were 14 (16.5%) underweight patients, 28 (32.9%) normal, 28 (32.9%) pre-obese and 15 (17.6%) obese. Values of MUAC and TSF were significantly different among the nutrition categories (p=0.000). The lowest MUAC and TSF values were in the underweight, and the highest in the obese. There was no significant difference of CRP and TNF-α among nutrition categories. Leptin of the underweight and normal nutrition was significantly different from leptin of the pre-obese and obese (p=0.000). The highest CRP and the lowest TNF-α and leptin were in the underweight patients. The obese had the lowest CRP (although increased as compared to normal values) and the highest leptin, while the pre-obese had the highest TNF-α.
Two basic nutrition disorders (underweight and obesity) were manifested in COPD patients. The inflammatory profile differs between underweight COPD patients and obese. Probably that happens due to systemic inflammation, and in part due to dysfunction of adipose tissue.
通过测定炎症介质血清值C反应蛋白（CRP）、肿瘤坏死因子α（TNF-α）和瘦素，检测慢性阻塞性肺疾病（COPD）患者的营养紊乱（体重过轻和肥胖）及全身炎症情况。
对85例COPD患者进行检查。通过体重指数（BMI）定义营养类别。通过上臂中部周长（MUAC）评估去脂体重（FFM），通过三头肌皮褶厚度（TFS）评估脂肪量（FM）。采用标准化酶联免疫吸附测定试剂盒测量TNF-α和瘦素的值，采用乳胶比浊法测量CRP的值。
有14例（16.5%）体重过轻患者，28例（32.9%）正常，28例（32.9%）肥胖前期，15例（17.6%）肥胖。营养类别之间的MUAC和TSF值存在显著差异（p = 0.000）。最低的MUAC和TSF值出现在体重过轻患者中，最高值出现在肥胖患者中。营养类别之间的CRP和TNF-α无显著差异。体重过轻和正常营养患者的瘦素与肥胖前期和肥胖患者的瘦素存在显著差异（p = 0.000）。体重过轻患者的CRP最高，TNF-α和瘦素最低。肥胖患者的CRP最低（尽管与正常值相比有所升高），瘦素最高，而肥胖前期患者的TNF-α最高。
COPD患者存在两种基本的营养紊乱（体重过轻和肥胖）。体重过轻的COPD患者和肥胖患者的炎症特征不同。这可能是由于全身炎症，部分原因是脂肪组织功能障碍。
