Chronic Obstructive Pulmonary Disease And Systemic Effects Of The Relationship Between Leptin Levels

ObjectiveThrough measuring the levels of leptin in patients with chronic obstructive pulmonary disease (COPD) in various phases, to explore the role of leptin in inflammatory and malnutrition, and the value of leptin on evaluating the severity of condition in patients with COPD.Methods⑴Forty-two male patients with COPD in acute exacerbation phase (groupⅠ),these patients relief of symptoms after treatment(groupⅡ),and thirty male healthy controls were studied.⑵Routinely, the general information of age and height were recorded and determined. Nutrition parameters: Body mass, body mass index (BMI),percent of ideal body weight(IBW%),serum albumin(ALB),and total lymphocyte counts were determined. Pulmonary function test: the forced expiratory volume in one second (FEV1), forced vital capacity, calculated and the value of percentage of FEV1 to predicted value and FEV1/FVC.Detects the CRP levels and blood gas analysis parameters: Partial pressure of oxygen in arterial blood (PaO2), partial pressure of carbon dioxide in arterial blood (PaCO2), oxygen saturation (SaO2).The serum leptin levels was detected by ELISA.⑶The general information and nutrition parameters with COPD patients and controls were compared, and the serum leptin,CRP and blood gas analysis levels of patients with COPD in acute exacerbation and symptomatic remission and controls were also compared. The correlation between the leptin and CRP,blood gas parameters and nutrition parameters of patients with COPD in acute exacerbation were analyzed. Results⑴BMI,IBW%,ALB and TLC in COPD patients were significantly lower than those in controls(P<0.01).⑵The leptin,CRP and PaCO2 levels were higher in groupⅠthan that in groupⅡandcontrols(P<0.05), and the PaO2,SaO2 levels were lower in group I than that in groupⅡand controls(P<0.05). The leptin,CRP and PaCO2 levels were higher in groupⅠthan that in groupⅡ, and the PaO2,SaO2 levels were lower in group I than that in groupⅡ(P<0.01).⑶Through linear correlation analysis:leptin levels in groupⅠhave positive correlation with CRP and PaCO2 (P<0.05),and have negative correlation with PaO2,SaO2 and ALB(P<0.05).Leptin levels in COPD of exacerbation phase have no correlation with BMI and IBW%(P>0.05).Conclusions⑴COPD groups were lower than normal nutrition indices, indicating that the prevalence of malnutrition in COPD patients.⑵Serum leptin levels significantly increased in acute exacerbation of COPD, was positively correlated with CRP levels, and CRP is widely recognized as inflammatory factors, suggesting that leptin may reflect the acute exacerbation of COPD patients with inflammatory cytokine levels and acute exacerbation of illness risk factors; serum leptin levels was negatively correlated with nutritional parameters, suggesting that leptin may be risk factors for malnutrition in COPD patients.⑶Serum leptin levels in acute exacerbation of COPD and the control group than in remission, and remission and control group, there were significant differences between the two, suggesting that leptin levels in COPD patients than normal control group, leptin levels may be COPD severity is related to evaluation of their severity, but also that there is still in remission COPD systemic inflammatory response, remission of leptin in COPD patients may lose their physiological regulation.⑷COPD patients with acute exacerbation of leptin levels and BMI have no significant correlation, consider the acute exacerbation of the normal feedback regulation of leptin is interrupted, a temporary separation, when the acute exacerbation of COPD may be associated with systemic inflammatory response.⑸C OPD with acute exacerbation of ALB levels were significantly lower, leptin levels were significantly increased, both significantly negatively correlated, suggesting that leptin in the acute inflammatory response in COPD, but also may affect protein metabolism, leading to increased malnutrition in patients.⑹Prevalence of COPD in patients with abnormal blood gas, oxygen both have carbon dioxide retention, that hypoxia and (or) carbon dioxide retention may be one reason for elevated leptin levels may increase the incidence of malnutrition in the development of COPD patients.