Research On The Relationship Between Leptin And TNF-α Levels And Nutritional State In Patients With Chronic Obstructive Pulmonary Disease

[Objectives]Through measuring the levels of leptin and TNF-αin patients with chronic obstructive pulmonary disease in various phases,to approach their relationship to nutrition state and lung functions.[Materials and Methods]1.Research object:Twenty-one COPD patients in acute exacerbation phase(groupâ… ), 20 COPD patients in stationary phase(groupâ…¡) and 15 healthy controls were studied. COPD diagnostic code accord with the COPD guide published in 2002.To eliminate the effects of sex difference,all patients and controls were male.there was no incorporate disease which influencing metabolic and nutritional state such as malignancies,gastrointestinal disorders,diabetes mellitus;thyroid disease,active lung tuberculosis,rheumatic disease,liver or kidney functional disturbance,cardiac insufficiency and other wasting disease.2.Nutrition parameters:Body height,body mass,body mass index(BMI),percentage of ideal body weight(IBW%),triceps skin-fold thickness(TSF),mid-upper arm circumference(MAC),serum albumin(ALB),total lymphocyte counts(LYM) were determined.All subjects with post-bronchodialator FEV₁/FVC less than 70%were identified as having COPD after other known cause of airflow limitation were excluded.3.Pulmonary function test:All people participated in this study have measured forced vital capacity(FVC),forced expiratory volume in the first second(FEV₁),calculated the value of percentage of FEV1 to predicted value and FEV₁/FVC.4.Measuring the content of leptin and TNF-αin blood serum:All subjects were collected 5 milliliter ulnar vein blood,to separate serum through centrifuge 15 minutes with speed of 3000r/min,the serum put to the icebox below zero 70 degree.Leptin and TNF-αlevels were measured by radioimmunoassay.[Results]1.BMI,IBW%,TSF,MAC,ALB and LYM in COPD patients were significantly lower than those in healthy controls(p＜0.01).2.Serum leptin levels were significantly higher in groupâ… (10.51±3.60ng/ml) than that in healthy controls(6.27±1.83ng/ml) and in groupâ…¡(3.79±0.81ng/ml)(p＜0.01); Serum Leptin levels were significantly lower in groupâ…¡than that in healthy controls (p＜0.01).Serum TNF-αlevels in groupâ… were significantly higher than that in healthy controls and in groupâ…¡(p＜0.01),while serum TNF-αlevels in groupâ…¡were higher than that in healthy controls(p＜0.01).3.Through linear correlation analysis,serum leptin levels in COPD of stable phase have positive correlation with BMI(r=0.484～0.675,p=0.006～0.031) and have positive correlation with IBW%(r=0.703～0.723,p=0.003～0.000);serum leptin levels in COPD of exacerbation phase have no correlation with BMI and IBW%(r=0.027～0.079, p=0.908～0.734),there was no correlation between leptin levels to TNF-αlevels in all groups(r=-0.157～0.292,p=0.509～0.199).[Conclusions]1.Serum leptin and TNF-αlevels in acute exeacerbation of COPD were significantly higher than those in the stable patients with COPD and controls,they probably were cytokines which reflected inflammatory degree of the acute exeacerbation phase of COPD and may contribute to aggravation and malnutrition in patients with COPD.2.Serum leptin levels in patients with COPD in stable phase were significantly lower than those in acute exeacerbation ones and in controls,have positive correlations with nutritional parameters,suggested that serum leptin levels in stable phase of COPD still maintained physiologic regulation.