1 First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
Ann Am Thorac Soc. 2014 Dec;11(10):1511-9. doi: 10.1513/AnnalsATS.201408-351OC.
The rate of annual change in FEV1 is highly variable among patients with chronic obstructive pulmonary disease (COPD). Reliable blood biomarkers are needed to predict prognosis.
To explore plasma biomarkers associated with an annual change in FEV1 in patients with COPD.
Plasma samples of 261 subjects, all Japanese, with COPD from the 5-year Hokkaido COPD cohort study were analyzed as a hypothesis-generating cohort, and the results were validated using data of 226 subjects with and 268 subjects without airflow limitation, mainly white, from the 4-year COPD Quantification by Computed Tomography, Biomarkers, and Quality of Life (CBQ) study conducted in Denmark. The plasma samples were measured using Human CardiovascularMAP (Myriad RBM, Austin, TX), which could analyze 50 biomarkers potentially linked with inflammatory, metabolic, and tissue remodeling pathways, and single ELISAs were used to confirm the results.
Higher plasma adiponectin levels and a lower leptin/adiponectin ratio at enrollment were significantly associated with an annual decline in FEV1 even after controlling for age, sex, height, and body mass index in the Hokkaido COPD cohort study (P = 0.003, P = 0.004, respectively). A lower plasma leptin/adiponectin ratio was also significantly associated with an annual decline in FEV1 in subjects with airflow limitation in the CBQ study (P = 0.014), the patients of which had largely different clinical characteristics compared with the Hokkaido COPD cohort study. There were no significant associations between lung function decline and adipokine levels in subjects without airflow limitation.
A lower leptin/adiponectin ratio was associated with lung function decline in patients with COPD in two independent Japanese and Western cohort studies of populations of different ethnicity. Measure of systemic adipokines may provide utility in predicting patients with COPD at higher risk of lung function decline.
慢性阻塞性肺疾病（COPD）患者的 FEV1 年变化率差异很大。需要可靠的血液生物标志物来预测预后。
探讨与 COPD 患者 FEV1 年变化相关的血浆生物标志物。
分析了来自北海道 COPD 队列研究的 261 名日本 COPD 患者的血浆样本，作为假设生成队列，并使用丹麦进行的为期 4 年的 COPD 通过计算机断层扫描、生物标志物和生活质量（CBQ）研究中 226 名有气流受限和 268 名无气流受限的患者的数据进行验证。使用 Human CardiovascularMAP（Myriad RBM，Austin，TX）测量血浆样本，该系统可以分析 50 种潜在与炎症、代谢和组织重塑途径相关的生物标志物，并用单 ELISA 确认结果。
在北海道 COPD 队列研究中，即使在校正年龄、性别、身高和体重指数后，较高的血浆脂联素水平和较低的瘦素/脂联素比值与 FEV1 的年下降显著相关（P=0.003，P=0.004）。在 CBQ 研究中，较低的血浆瘦素/脂联素比值也与有气流受限患者的 FEV1 年下降显著相关（P=0.014），与北海道 COPD 队列研究相比，这些患者的临床特征有很大不同。在无气流受限的患者中，肺功能下降与脂联素水平之间没有显著相关性。
在两个独立的日本和西方队列研究中，不同种族人群的 COPD 患者中，较低的瘦素/脂联素比值与肺功能下降相关。系统脂联素的测量可能有助于预测肺功能下降风险较高的 COPD 患者。
