PURPOSE: Chronic obstructive pulmonary disease(COPD) is a syndrome of chronic wasting. This study aimed to investigate role of plasma leptin and TNF-alpha levels in the malnutrition of COPD patients.
METHODS: Sixty COPD and ten control subjects participated in this study.COPD patients were divided into 3 groups:Group I: Patients without malnutrition, during acute exacerbation( n=20); Group II: Patients without malnutrition, during stable disease( n=20); and Group III: Patients with malnutrition during stable disease(n=20).All patients and controls were males. Body mass index (BMI), triceps skin-fold thickness (TSF), mid-upper arm circumference (MAC), mid-upper arm muscle circumference (MAMC), serum leptin and TNF-alpha levels, serum transferrin (TF), serum albumin (Alb),serum prealbumin, total lymphocytes count (TLC), forced expiratory volume in one second (FEV1), maximal inspiration pressure (MIP) and maximal expiration pressure (MEP) were measured. Leptin levels were measured by ELISA; TNF-alpha levels were measured by ELISA. The between group difference and correlation of these parameters were analyzed.
RESULTS: Nutritional parameters were significantly lower in Group 111 than other groups(P<0.05). Serum leptin levels were significantly lower in Group III[(5.7±2.7) ng/ml] than in Group II[(9.7±5.3) ng/ml] and controls [(12.2±2.5) ng/ml] (P <0.05). However, the difference between Group I, Group II and controls was not statistically significant (P >0.05). There was no statistically significant difference in serum TNF-alpha; levels between Group I, Group II, Group III and controls (P >0.05). There was no significant correlation between leptin and TNF-alpha in any group.
CONCLUSION: Leptin was not involved in weight loss of COPD patients. There was no significant difference in serum leptin levels between COPD patients during stable stage and acute exacerbation, and there was no significant correlation between TNF-alpha and leptin during the regulation of energy balance in COPD patients.In addition,circulating leptin works independently of the TNF-alpha system and does not primarily affect BMI in COPD patients.
CLINICAL IMPLICATIONS: The physiologic regulation of leptin is maintained despite weight loss in COPD patients,circulating leptin works independently of the TNF alpha system and does not primarily affect BMI in patients with COPD.
DISCLOSURE: Tawfik Elsaid, No Financial Disclosure Information; No Product/Research Disclosure Information