Tonon Federica, Di Bella Stefano, Giudici Fabiola, Zerbato Verena, Segat Ludovica, Koncan Raffaella, Misin Andrea, Toffoli Barbara, D'Agaro Pierlanfranco, Luzzati Roberto, Fabris Bruno, Bernardi Stella
Department of Medical Surgical and Health Sciences, University of Trieste, Trieste 34149, Italy.
SC Malattie Infettive, Ospedale Maggiore, Azienda Sanitaria Universitaria Isontino-Giuliana, Trieste 34125, Italy.
Int J Endocrinol. 2022 Apr 26;2022:9908450. doi: 10.1155/2022/9908450. eCollection 2022.
Obesity is a risk factor for severe coronavirus disease 2019 (COVID-19). Circulating adipokines have been associated with inflammatory burden and amplified or dysregulated immune responses. This study aimed to evaluate the discriminatory ability of adipokines to identify COVID-19 pneumonia and to assess disease severity.
We conducted an observational case-control study, with a prospective design, and recruited patients with diagnosis of COVID-19 pneumonia ( = 48) and healthy controls ( = 36), who were matched by age, sex, and BMI. Leptin, adiponectin, IL-6, and TNF- were measured by ELISA.
Patients with COVID-19 pneumonia had higher levels of leptin, lower adiponectin/leptin (Adpn/Lep) ratio, and higher expression of IL-6. Leptin had an acceptable discriminatory accuracy for COVID-19 pneumonia in patients with BMI >30 (AUC 0.74 [0.58, 0.90]) with a cutoff of 7852 pg/mL and it was associated with maximum respiratory support. By contrast, Adpn/Lep had an excellent discriminatory accuracy for COVID-19 pneumonia in patients with BMI <25 (AUC 0.9 [0.74, 1.06]) with a cutoff of 2.23.
Our data indicate that high Adpn/Lep (>2.23) in lean patients is consistent with a state of good health, which decreases in case of inflammatory states, ranging from adipose tissue dysfunction with low-grade inflammation to COVID-19 pneumonia.
肥胖是2019冠状病毒病（COVID-19）重症的一个危险因素。循环中的脂肪因子与炎症负担以及免疫反应的增强或失调有关。本研究旨在评估脂肪因子对COVID-19肺炎的鉴别能力，并评估疾病严重程度。
我们进行了一项前瞻性设计的观察性病例对照研究，招募了确诊为COVID-19肺炎的患者（n = 48）和健康对照者（n = 36），并按照年龄、性别和体重指数进行匹配。通过酶联免疫吸附测定法（ELISA）检测瘦素、脂联素、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）。
COVID-19肺炎患者的瘦素水平较高，脂联素/瘦素（Adpn/Lep）比值较低，IL-6表达较高。在体重指数>30的患者中，瘦素对COVID-19肺炎具有可接受的鉴别准确性（曲线下面积[AUC]为0.74[0.58, 0.90]），截断值为7852 pg/mL，且与最大呼吸支持相关。相比之下，在体重指数<25的患者中，Adpn/Lep对COVID-19肺炎具有出色的鉴别准确性（AUC为0.9[0.74, 1.06]），截断值为2.23。
我们的数据表明，瘦人高Adpn/Lep（>2.23）与健康状态一致，在炎症状态下该比值会降低，范围从伴有低度炎症的脂肪组织功能障碍到COVID-19肺炎。
