| In recent years,with the increase of the aging population and air pollution,the incidence of COPD increased year by year, It is now in the fourth place ofdeath reasons, and it will become the third leading cause of death worldwide by2020.In addition, with the further and in-depth research, people realized that thedisease of COPD is not a simple disease limited to the lungs, but a systemicdisease with extensive extrapulmonary effects. Malnutrition as one of theextrapulmonary effects seriously affected the progression and prognosis ofpatients with COPD. And there is a certain correlation between the abnormallipid metabolism and the weight loss patients with COPD. So in clinicaltreatment, we should improve the respiratory function of COPD patients,andgive the patients nutrition support therapy, maintain the balance of lipidmetabolism at same time, which might have great significance in theimprovement of the prognosis and the quality of the life in patients with COPD.Objective:The purpose of this article is to explore the characterstics of the lipidmetabolism in patients with chronic obstructive pulmonary disease underdifferent nutrition conditions, and to further explore the probable mechanism ofabmornal lipid metabolism in COPD patients by measuring the serum leptinand adiponectin levels.Methods:Selecting60outpatients with the diagnosis for the chronic obstructivepulmonary disease（the lung function II Level or III Level）in the First ClinicalHospital of Jilin University between January2012and October2012and whoare now in a stable period as the observation group.20healthy volunteers who took physical examination at examination center of the First Clinical Hospitalof Jilin University as the control group.60patients were randomly divided intotwo groups according to the body mass index, the none marasmus group andthe marasmus group,the BMI of the none marasmus group, the average BMI ofmen is23.46±0.83, the average BMI of women is22.46±0.47, the BMI of thenone marasmus group, the average BMI of men is17.8±0.52, the average BMIof women is16.33±0.77, the patients of the two groups have no statisticallysignificant difference in gender and age,we detected the serum lipid(includingthe serum triglyceride, total cholesterol,high density lipoprotein cholesterol,lowdensity lipoprotein cholesterol) levels by the means of extracting5ml venousblood by the time of6:00-7:00early in the morning,and detected the serumleptin and adiponectin levels by the means of ELLSA, to see whether there wasstatistics difference among the three groups.Results:1. Compared with the control group, the serum triglyceride and totalcholesterol of the marasmus group and the none marasmus group of COPDpatients in stable phase were decreased（P<0.05）, and the marasmus groupdecreased siginificantly（P<0.05）, Compared with the control group,the serumhigh density lipoprotein cholesterol and low density lipoprotein cholesterol ofthe marasmus group and the none marasmus group of COPD patients in stablephase were decreased, but there were no difference among the three groups（P>0.05）.2. Compared with the control group, the leptin level of the none marasmusgroup and the marasmus group both decreased（P<0.05）, and the marasmusgroup decreased siginificantly（P<0.05）. Compared with the control group, theadiponectin level of the none marasmus group and the marasmus group bothincreased （P<0.05）, and the marasmus group increased siginificantly （P<0.05）.3. There was a positive correlation between the lipid level (including theserum triglyceride, total cholesterol,high density lipoprotein cholesterol, lowdensity lipoprotein cholesterol) and the serum leptin level in COPD patients instable period （P<0.05）, and there was a negative correlation between the lipidlevel and the serum adiponectin level.Conclusion:1. There was obvious decrease in blood lipid level in COPD patients thatwere in stable period (including the none marasmus group and the marasmusgroup), and there was significant decrease in COPD patients accompany withmalnutrition. It is suggested that the patients should be treated with thenutrition support therapy as well as the improving of the respiratory function.2. The serum leptin level of the COPD patients in stable period decreasedand showed a significant positive correlationship with the serum lipid level,indicated that leptin may be a physiological regulator of lipid metabolism inpatients with COPD, and the change of the lipid level may be a compensatorymechanism to maintain body fat.3. The serum adiponectin level in the stable COPD patients increased,andshowed a significant negetive correlationship with the serum lipid level, theresults suggested that the secretion of adiponectin increased when the serumlipid content decreased, although the serum adiponectin was secreted byadipose tissue, it may be related with the upregulation of the systemic andpulmonary expression of adiponectin,the mechanism need further studies. |
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