Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates; Space Medicine Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates; Cardiovascular Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates.
Medical Oncology Department, Hayatabad Medical Complex, Peshawar 25000, Khyber Pakhtunkhwa, Pakistan.
Clin Nutr ESPEN. 2024 Aug;62:157-163. doi: 10.1016/j.clnesp.2024.05.018. Epub 2024 May 28.
Patients with chronic obstructive pulmonary disease (COPD) frequently exhibit an inability to maintain postural balance. However, the contribution of increased intestinal permeability or leaky gut to the postural imbalance in COPD is not known.
We measured plasma zonulin, a marker of leaky gut, with relevance to postural balance in male controls (n = 70) and patients with mild (n = 67), moderate (n = 66), and severe (n = 58) COPD. We employed a short physical performance battery to evaluate postural balance in supine, tandem, and semi-tandem positions. We also measured handgrip strength (HGS), gait speed, plasma c-reactive proteins (CRP), and 8-isoprostanes as potential mechanistic connections between postural imbalance and leaky gut.
COPD patients demonstrated higher plasma zonulin, CRP, and 8-isoprostanes levels and lower balance, HGS, and gait speed than controls (all p < 0.05). These findings were more robust in patients with moderate and severe than mild COPD. In addition, plasma zonulin exhibited significant potential in diagnosing poor balance, low HGS, and gait speed in COPD patients (all p < 0.05). We also found significant correlations of plasma zonulin with CRP and 8-isoprostanes, providing heightened inflammation and oxidative stress as mechanistic connections between leaky gut and postural imbalance.
Plasma zonulin may be helpful in evaluating postural imbalance in COPD patients. Repairing intestinal leaks can be a therapeutic target to improve postural control in COPD.
慢性阻塞性肺疾病（COPD）患者常表现出无法维持姿势平衡。然而，增加的肠道通透性或肠漏是否导致 COPD 中的姿势失衡尚不清楚。
我们测量了男性对照组（n=70）和轻度（n=67）、中度（n=66）和重度（n=58）COPD 患者的血浆封闭素，这是一种与姿势平衡相关的肠漏标志物。我们采用短体性能量测试来评估仰卧位、并足位和半并足位的姿势平衡。我们还测量了手握力（HGS）、步态速度、血浆 C 反应蛋白（CRP）和 8-异前列腺素作为姿势失衡和肠漏之间潜在的机制联系。
COPD 患者的血浆封闭素、CRP 和 8-异前列腺素水平较高，平衡、HGS 和步态速度较低，与对照组相比均有显著差异（均 p<0.05）。在中度和重度 COPD 患者中，这些发现更为明显。此外，血浆封闭素在 COPD 患者中对诊断平衡不良、HGS 低和步态速度慢具有显著潜力（均 p<0.05）。我们还发现血浆封闭素与 CRP 和 8-异前列腺素之间存在显著相关性，提示肠道通透性增加与炎症和氧化应激之间存在潜在的机制联系。
血浆封闭素可能有助于评估 COPD 患者的姿势失衡。修复肠道渗漏可能是改善 COPD 患者姿势控制的治疗靶点。
