Department of Respiratory Diseases, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
Department of Respiratory Diseases, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2019 Jul 15;14:1559-1566. doi: 10.2147/COPD.S197164. eCollection 2019.
The purpose of this study was to explore the insulin level in the serum of chronic obstructive pulmonary disease (COPD) patients during acute exacerbation (AE).
The study population consisted of 22 acute exacerbation chronic obstructive pulmonary disease (AECOPD) patients, 20 COPD patients and 20 healthy controls. Fasting blood glucose, insulin and serum lipid levels were measured. After the patients recovered from AE, the insulin and glucose levels were also analyzed.
Insulin level, glucose level and homeostasis model assessment of insulin resistance (HOMA-IR) of AECOPD patients were higher than healthy controls (7.19±6.02 vs 3.28±1.09 μIU/mL, <0.05, 126.61±50.92 vs 96.21±12.66 mg/dL, <0.05, 2.66±2.72 vs 0.78±0.26, <0.05). For stable COPD patients, the insulin level, glucose level and HOMA-IR were 6.52±2.56 μIU/mL, 95.58±11.44 mg/dL, and 1.52±0.53, respectively. The triglyceride (TG) level, total cholesterol (CHOL) level and low-density lipoprotein cholesterol (LDL-CHOL) level were decreased in AECOPD patients (0.78±0.33 vs 1.05±0.35 mmol/L, <0.05, 3.88±0.72 vs 4.49±0.7 mmol/L, <0.05, 2.01±0.59 vs 2.59±0.58 mmol/L, <0.05). When the patients had recovered from AE, the insulin levels increased (10.67±6.22 vs 7.12±6.19 μIU/mL, <0.05) and the glucose levels decreased (122.69±41.41 vs 134.08±53.19 mg/dL, >0.05).
A high insulin level and a high HOMA-IR status in COPD patients were demonstrated. Downregulated levels of insulin during AE compared with the convalescent state were detected, while the variation in the glucose level was not as great as expected, indicating a potentially important role for insulin in AECOPD.
本研究旨在探讨慢性阻塞性肺疾病（COPD）急性加重（AE）患者血清中的胰岛素水平。
研究人群包括 22 例急性加重期慢性阻塞性肺疾病（AECOPD）患者、20 例 COPD 患者和 20 例健康对照者。检测空腹血糖、胰岛素和血清脂质水平。在患者 AE 缓解后，还分析了胰岛素和血糖水平。
AECOPD 患者的胰岛素水平、血糖水平和胰岛素抵抗评估的稳态模型（HOMA-IR）均高于健康对照组（7.19±6.02 比 3.28±1.09 μIU/mL，<0.05，126.61±50.92 比 96.21±12.66 mg/dL，<0.05，2.66±2.72 比 0.78±0.26，<0.05）。对于稳定期 COPD 患者，胰岛素水平、血糖水平和 HOMA-IR 分别为 6.52±2.56 μIU/mL、95.58±11.44 mg/dL 和 1.52±0.53。AECOPD 患者的甘油三酯（TG）、总胆固醇（CHOL）和低密度脂蛋白胆固醇（LDL-CHOL）水平降低（0.78±0.33 比 1.05±0.35 mmol/L，<0.05，3.88±0.72 比 4.49±0.7 mmol/L，<0.05，2.01±0.59 比 2.59±0.58 mmol/L，<0.05）。当患者从 AE 中恢复时，胰岛素水平升高（10.67±6.22 比 7.12±6.19 μIU/mL，<0.05），血糖水平降低（122.69±41.41 比 134.08±53.19 mg/dL，>0.05）。
COPD 患者存在高胰岛素水平和高 HOMA-IR 状态。与缓解期相比，AE 期间胰岛素水平降低，而血糖水平的变化并不如预期的那样大，表明胰岛素在 AECOPD 中可能具有重要作用。
