Correlation Study Between Visfatin With Its Gene Polymorphisms And Nutrition Station In Copd

BackgroundChronic Obstructive Pulmonary Disease(COPD) is a common disease and frequently-occurring disease.Recently,with the population aging,increase of the smoking population,deterioration of the enviromental and the frequently-occurring of the extreme weather,it has the trend of higher incidence with the years.Epidemiological data showed that COPD is the fourth death cause in city and the first death cause in county. At present,because of its high morbidity and mortality and heavy economic burden,COPD has become an important public health problem.WHO also pointed that COPD will be the fifth disease of world economic burden in 2020.COPD patients are often accompanied with malnutrition.Malnutrition is the independent risk factor of prognosis.it is the important death cause of respiratory failure.but the mechanism of COPD with mulnutrition is complex,it is not totally clear now. One of the characteristic of COPD with mulnutrition is body weight loss and fat failure.New study showed that inflammatory factor leptin thyroxine may be the reason of COPD patients with malnutrition poorly reacted by nutrition surport. In 2005,Fukuhara discovered a kind of new adipocytokine and is named visfatin, Study showed that it can combine and activate insulin receptor and conduct the effect of lower the blood glucose as insulin,furthermore,it can enhance the diferentiation and accumulation of fat.It may be an target to relate the obese energy balance and diabetes.Moreover visfatin has regulate the inflammationand immune reaction.It may be participate the occuring devolepment and prognosis of COPD as a role of inflammatory medium.There are many study to show that visfatin has corrrlation with glucose and lipid. Many study showed that besides the environmental factors the gene polymorphysism factors also participate in the pathogenesis of COPD.Genetics study is the fundamental methods of the disease?It has important significance to COPD patients to take measure early from pathophysiological level to etiology level.The prognosis of COPD is closed with nutrition station.Visfatin as a kind of new adipocytokine,which can lower the blood glucose and imitate the effect of insulin,take part in the inflammatory reaction,regulate the blood lipid and cardiovascular function,participate the energy matabolisn. We speculate in theory that visfatin correlate with nutrition station in COPD.At present,there is a controversial problem about the visfatin level in COPD.For example,the study of Ekers poined out that the visfatin level deceased in COPD patients,but the study of Liu Xiaojing showed that it increased in COPD patients,and it may be an proinflammatory adipocytokine.The study is still much less about visfatin gene polymorphysism in COPD patients at home and abroad study.Then how is the concention of visfatin in COPD patients?Which factor can affect the visfatin level?Whether or not visfatin correlate with nutrition parameter?Whether its gene polymorphism correlate with its level and nutrition parameter? Because of these questions,we carried out the present study and tried to find satisfying answers to all the above problems. Objectives1. To investigate the plasma concentration of visfatin in COPD group and normal control group,and its correlationship with the factors of sex?age?BMI?MAC?WHR?TG?CH?LDL?FBG?FEV1?FEV1%?FEV1/FVC?6MWT.2. To investigate the genotype distribution of visfatin -1535 single necleotide C/T polymorphism and its correlation with visfatin level lipid glucose and BMI in the COPD patients.Methods1.120 Subjects with COPD was selected at random(64.76±10.95 yr of age,males 86,females 34)and 120 subjects of normal control group (63.15±7.23 yr of age, males 90,females 30)was selected with age and sex matched.Serum visfatin was measured by ELISA assay.BMI,WHR,MAC were measured. Furthermore, fasting blood sample was collected from each subjects after 12-14 hours fast to determine the fasting blood glucose(FBG), cholesterol(CH), triglycerides(TG)?low-density lipoprotein cholesterol(LDL-C), and Albumin. Lung function and 6MWT were conducted too.Study the relationship between these factor and serum visfatin concentration. Linear correlation analysis and multiple stepwise regression analysis were conducted to investigate the correlation between visfatin and risk factors.2.120 normal control group and 120 COPD group were genotyped for the polymorphism of visfatin by PCR-RFLP assays.To analyze the relation between the SNP and visfatin concentration glucose and lipid of COPD.Results1. Clinical characteristics of the control group and COPD group:There were no significant differences in age and gender between COPD group and control group(P>0.05). Compared wim controls, BMI?MAC?WHR?FEV1?FEV1%? FEV1/FVC?6MWT was significantly lower in COPD group(P<0.05).2.The changes of serum visfatin:Compared with the control group (28.66±2.62) ng/ml,the serum concentration of visfatin in COPD group (19.88±1.50) ng/ml was significantly lower (P<0.05)3. Sex effect fo visfation:To the whole subjects,the serum concentration of visfatin in female was higher notalbly (P<0.05).But in COPD group,it has no such result (P>0.05).In normal control group, the serum concentration of visfatin in female was higher notalbly (P<0.05)?4. Age effect to visfatin:In normal control group?all subjects and COPD group and male and female group,it has no notable correlation (P>0.05)5. BMI effect to visfatin::In all subjects and COPD group, was detected visfatin concentration was more higher in high BMI group than that of low BMI group (P<0.05).But in normal control group,it has no difference (P>0.05)6. The result of Pearson linear correlation of visfatin and each index and the result of multiple regression analysis with visfatin as the dependent variable:In all subjects,the concentration of visfatin has positive correlation with BMI?WHR?MAC and FBG?FEV1(P<0.05);while in COPD group it has positive correlation with BMI?WHR?MAC and FBG?FEV1.6MWT (P<0.05).In normal control group, the concentration of visfatin has positive correlation with BMI?WHR?MAC (P<0.05). In multiple regression analysis to all subjects, only BMI and MAC remains positively correlated with visfatin in COPD group.7. The genetype of visfatin gene-1535C/T:The frequency distribution of TT TC CC genetype in COPD group was 32.6% 38.2% 29.2% respectively,while in normal group was 32.3%?35.1%?32.6% respectively?There was no significant difference about SNPs-1535 C/T genotype frequency and allele frequency distribution between the two groups (P>0.05).8. There was no significant difference about visfatin level in the 3 genetype in both COPD group and normal control group(P>0.05).9. In COPD group, FBG level was higher in TT genotype than that of others genotype (P<0.05).while the LDL level was higher than that of other genotype,too(P<0.05).there wasn't notable difference about genetype distribution in the different BMI group (P>0.05).Conclusion1. In summary, we found that in COPD group,serum visfatin was significantly lower than that of normal control group. It has positive correlation with BMI?WHR?MAC and FBG?WBC?FEV1.6MWT (P<0.05). In multiple regression analysis to all subjects, only BMI and MAC remains positively correlated with visfatin.That suggested that visfatin may participate in the change of nutrition station in COPD and take part in the development of COPD.2. The concentrition of visfatin had no significant difference in the 3 type of genetype.That suggested that gene polymorphism had no regulation effect on visfatin level.3.The polymorphism of visfatin -1535 nueleotide C/T was associated with glucose and lipid metabolism in COPD.