Objective: To determine associations between the adipokines tumor necrosis factor-α (TNF-α) and its receptors sTNFR I, II, leptin, adiponectin, resistin, ghrelin, pulmonary function testing, bone mineral density (BMD) and nutritive status in severe COPD.
Materials and methods: We determined BMD, serum adipokine and ghrelin in 48 patients with severe COPD and and 52 age and sex matched controls.
Bone density at lumbar spine (LS) and femoral neck (FN) and parameters of body composition were measured by dual-energy X-ray absorptiometry.
Results: The levels of adiponectin, resistin, TNF-α and its receptors sTNFR I, II were higher, but leptin and ghrelin levels were low in COPD than in controls. It was a direct correlation between leptin level (r=0.58, P<0.05 at LS; r=0.64; P<0.01 at FN) and negative relationship between adiponectin (r=−0.54, P<0.05 at L2L4; r=−0.62; P<0.01 at FN), TNF-α (r=−0.58, P<0.01 at L2L4; at FN r=−0.64, P<0.01) and BMD. It was negative association between serum resistin (r=−43, P<0.05), sTNFR-I (r=−41, P<0.05), sTNFR-II (r=−0.44; P<0.05) and positive correlation with ghrelin (r=0.42, P<0.05) and BMD at FN only. Leptin, ghrelin concentrations had direct relationship with BMI, fat mass. Adiponectin level significantly inversely correlated with BMI, fat mass, resistin and sTNFR-I, II concentrations. It was correlations between SaO2, pCO2, pO2 and TNFR I, II, resistin, and the relationship between leptin, adiponectin, TNF-α levels and pCO2.
Conclusion: Results shows possibly role of adipokines and ghrelin in the increasing of bone loss in several COPD. However, larger studies are needed to further evaluate the relationship between adipokines, body weight, and BMD in patients with COPD.
Key words: bone mineral density, osteoporosis, TNF-α, leptin, adiponectin, ghrelin, resistin, chronic obstructive pulmonary disease, adipokines
17 May 2014 - 20 May 2014