The Relationship Between Tumor Necrosis Factor-alpha, Interleukin-6 And Leptin, Adiponectinin Patients With Acute Chronic Obstructive Pulmonarydisease

Objective To study the relationship between inflammatory reaction and disfunctions of glucolipid metabolism in patients with acute chronic obstructive pulmonary disease(AECOPD) through analyzed the level of tumor necrosis factor-alpha (TNF-α), interleukin-6(IL-6), leptin, adiponectin and their correalation.Methods 30 patients with AECOPD were studied as COPD group, 25 males and 5 females from 49 to 87 years, mean age(71.1±8.6)years; 25 healthy people were studied as control subjects, 21 males and 4 females from 55 to 85 years, mean age(72.3±5.6)years. Body height, body weight, TNF-α, IL-6,fasting insulin(FINS), leptin, adiponectin, fasting plasma glucose(FPG) and postprandial blood sugar were measured in all participants. FINS and TNF-αlevel were measured by radioimmunoassay, IL-6, leptin and adiponectin level were measured by enzyme-linked immunosorbent assay(ELISA), FPG and postprandial blood sugar level were measured by SureStep blood glucose meter. Calculate body mass indes(BMI) and homeostasis model assessment of insulin resistance index (HOMA-IR). The between group difference and correlation of these parameters were analyzed.Results1. BMI COPD group (21.96±3.94)was significant lower than control group, P<0.05.2. fasting plasma glucose, postprandial blood sugar and fasting insulin There was no statistically significant difference in fasting plssma glucose levels between COPD group and control group, P>0.1. The level of postprandial blood sugar(9.34±2.29)mmol/L, fasting insulin(13.43±1.96)mU/L and HOMA-IR(3.55±1.11)of COPD group were significant higher than control group[(7.46±2.70)mmol/L,( 3.60±2.17 ) mU/L and ( 0.90±0.62)], P<0.01.3.TNF-αand IL-6 The level of TNF-α(1.70±0.35)ng/ml and IL-6(87.70±7.68)pg/ml in COPD group were significant higher than control group[(0.50±0.24)ng/ml,(9.10±4.8)pg/ml], P<0.01.4.leptin and adiponectin The level of leptin in COPD group(2.66±1.41)ng/ml was significant higher than control group(1.58±0.87)ng/ml, P<0.05. Their was no statistically significant difference in adiponectin between COPD group(8.47±4.15)ng/ml and control group(10.08±4.00)ng/ml, P=0.112.5.the correlation of all parameters TNF-αand IL-6 have positive correlation with HOMA-IR(r=0.569,P<0.01;r=0.749,P<0.01), IL-6 has positive correlation with leptin (r=0.374,P<0.05)and negative correlation with adiponectin(r=-0.335,P<0.05).There was no significant correlation between TNF-αand leptin(r=0.153,P>0.1), TNF-αand adiponectin (r=-0.221,P>0.1).Conclusion The level of serum TNF-α, IL-6 and leptin were significant higher in patients with AECOPD and the level of serum adiponectin was downtrend; IL-6 has positive correlation with leptin and negative correlation with adiponectin, their was disfunctions of glucolipid metabolism and insulin resistance which may related with system inflammatory reaction in AECOPD.