Hirano Tsunahiko, Doi Keiko, Matsunaga Kazuto, Takahashi Shun, Donishi Tomohiro, Suga Kazuyoshi, Oishi Keiji, Yasuda Kasumi, Mimura Yusuke, Harada Misa, Suizu Sumiteru, Murakawa Keita, Chikumoto Ayumi, Ohteru Yuichi, Matsuda Kazuki, Uehara Sho, Hamada Kazuki, Ohata Shuichiro, Murata Yoriyuki, Yamaji Yoshikazu, Asami-Noyama Maki, Edakuni Nobutaka, Kakugawa Tomoyuki
Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan.
Department of Neuropsychiatry, Wakayama Medical University, Wakayama 641-8510, Japan.
J Clin Med. 2020 Aug 24;9(9):2737. doi: 10.3390/jcm9092737.
Sedentary behavior and cognitive impairment have a direct impact on patients' outcomes. An energy metabolic disorder may be involved in the overlap of these comorbid conditions (motoric cognitive risk (MCR)) in patients with chronic obstructive pulmonary disease (COPD). We aimed to explore the linkage between a proapoptotic protein, growth differentiation factor (GDF)-15, and MCR. Physical activity (PA), cognitive function (Japanese version of the Montreal Cognitive Assessment: MOCA-J), and the serum GDF-15 levels were assessed in healthy subjects ( = 14), asthmatics ( = 22), and COPD patients ( = 28). In the entire cohort, serum GDF-15 had negative correlations with exercise (Ex) ( = -0.43, < 0.001) and MoCA-J ( = -0.44, < 0.001), and Ex and MOCA-J showed a positive correlation ( = 0.52, < 0.0001). Compared to healthy subjects and asthmatics, COPD patients showed the highest serum GDF-15 levels and had a significantly higher proportion of subjects with MCR (both sedentary lifestyle (EX < 1.5) and cognitive risk (MoCA-J ≤ 25)). Also, we found that serum GDF-15 has a screening potential (100% sensitivity) greater than aging (67% sensitivity) for detecting MCR in COPD patients. In conclusion, higher serum GDF-15 had interrelationships with a sedentary lifestyle and cognitive risk. This protein was not disease-specific but could be a screening biomarker to detect MCR related to poor health outcomes of COPD patients.
久坐行为与认知障碍对患者的预后有直接影响。能量代谢紊乱可能参与慢性阻塞性肺疾病（COPD）患者这些合并症（运动认知风险（MCR））的重叠。我们旨在探讨促凋亡蛋白生长分化因子（GDF）-15与MCR之间的联系。对健康受试者（n = 14）、哮喘患者（n = 22）和COPD患者（n = 28）评估了身体活动（PA）、认知功能（日语版蒙特利尔认知评估：MOCA-J）和血清GDF-15水平。在整个队列中，血清GDF-15与运动（Ex）呈负相关（r = -0.43，P < 0.001），与MOCA-J呈负相关（r = -0.44，P < 0.001），Ex与MOCA-J呈正相关（r = 0.52，P < 0.0001）。与健康受试者和哮喘患者相比，COPD患者的血清GDF-15水平最高，且MCR受试者（久坐生活方式（Ex < 1.5）和认知风险（MOCA-J≤25））的比例显著更高。此外，我们发现血清GDF-15在检测COPD患者的MCR方面具有比年龄（敏感性67%）更高的筛查潜力（敏感性100%）。总之，较高的血清GDF-15与久坐生活方式和认知风险相关。这种蛋白并非疾病特异性的，但可能是一种筛查生物标志物，用于检测与COPD患者不良健康结局相关的MCR。
