The Levels Of Insulin-Like Growth Factor-? In Patients With Chronic Obstructive Pulmonary Disease And The Association With Lung Function And Bone Mineral Density

Objective:1?The serum levels of insulin-like growth-I(IGF-I) and growth hormone(GH)are evaluated in patients with chronic obstructive pulmonary disease(COPD).2?The relationship between IGF-I and lung function and bone mineral density is investigated in patients with COPD.Methods:70 patients with COPD and 35 healthy controls were admitted from May 2015 to January 2016 in respiratory department of the Second Affiliated Hospital of Nanchang University.Basic information such as age,gender,weight,smoking index and medication history were recorded.All the subjects took the lung function test,The forced expiratory volume in one second percent predicted value were recorded.The serum levels of insulin-like growth-I and growth hormone were measured in all the subjects.In addition,the COPD group also took the bone mineral density measurement,the bone mineral density(BMD) of lumbar(L1-L4) and the left side of proximal femur(including upper femoral neck, femoral neck, femoral neck lower,Wards triangle, great trochanter, femoral) were measured and recorded.The serum levels of IGF-I and GH was compared between the two groups. The COPD patients were divided into four groups according to the severity of airway obstruction.Because the sample size of mild group is small,three groups(mild-moderate group,severe group and extremely severe group) were classified finally.The serum levels of IGF-I and GH were compared between the three groups and controls.Then the COPD patients were divided into other three groups(osteoporosis,osteopenia and normal bone mineral density) according to the result of bone mineral density.The serum levels of IGF-I were compared between the three groups.Finally,The relationship between IGF-I and FEV1% predicted and bone mineral density was analysed in patients with COPD.All the results were analyzed using SPSS 20.0.Results:1 ? The mean level of IGF-I in COPD group was 66.10(48.93~103.20)ug/L,logIGF-I was(1.83±0.28) and the GH was 1.40(1.08~2.07) mg/ml.The mean level of IGF-I in control group was 102.0(82.9~123.0) ug/L,logIGF-I was( 2.00±0.18) and the GH was 1.73(1.10~2.36)mg/ml.The levels of IGF-I and logIGF-I were found to be significantly lower in COPD group compared to the controls(P=0.001 and P < 0.001),there was no significant difference in serum GH levels between COPD group and control group(P=0.229).2?The COPD patients were devided into three groups according to the results of lung function.The mean level of logIGF-I is(1.93±0.21) and GH is 1.73(1.17~2.11)mg/ml in mild-moderate COPD patients,The mean level of logIGF-I is(1.89±0.22)and GH is 1.27(0.96~1.92)mg/ml in severe COPD cases,the logIGF-I is(1.74±0.33)and GH is 1.33(1.12~2.07)mg/ml in extremely severe COPD patients.After adjustment for body mass index,there was significant difference in logIGF-1 between extremely severe COPD patients and healthy controls(P < 0.01),there was no significant difference in logIGF-I between the other groups(P>0.05).There was no significant difference too in GH between any two groups(P>0.05).3?There were 67 COPD patients take the bone mineral density measurement,They were devided into three groups according to the bone mineral density.19 patients were diagnosed with osteoporosis and the mean level of logIGF-I was(1.80±0.23). 36 patients were diagnosed with osteopenia and the logIGF-I was(1.78±0.43).The logIGF-I in 12 COPD patients with normal bone mineral density was( 1.94±0.21).Arter correcting age,body mass index,there was no significant difference in logIGF-I between the three groups(P>0.05).4 ? The bone mineral density(BMD) of lumbar(L1-L4) and left femoral were positively correlated with logIGF-I in COPD patients.While logIGF-I in COPD patients was not significantly correlated to BMD of the other measured sites and FEV1% predicted.Conclusion:1?The serum levels of IGF-I were decreased in COPD patients,but the declineoccurred mainly in extremely severe group,while the serum levels of GH had barely changed.2?The serum levels of IGF-I were positively correlated with the bone mineral density(BMD) of lumbar(L1-L4) and left femoral,not significantly correlated to FEV1% predicted and the BMD of the other measured sites.