| Background:Chronic obstructive pulmonary disease(COPD)is a respiratory disease characterized by persistently restricted airflow,with sarcopenia being one of its common complications.Sarcopenia is a part of geriatric syndrome,characterized by progressive reduction of skeletal muscle.Sarcopenia is prevalent in elderly patients hospitalized for acute disease,and can increase the mortality rate of patients.Therefore,the investigation on the risk factors for sarcopenia has profound effect on improving the patients'prognosis and quality of daily life.Objective:This study collects clinical data of COPD patients,uses DXA test to analyze patients'skeletal muscle mass and ELISA test to detect plasma IL-6 and IL-10 concentrations.Besides,comparing the serum IL-6 and IL-10 concentrations of patients who suffer from COPD and sarcopenia with patients only suffering COPD to discuss the Influence of IL-6,IL-10 concentrations on muscle reduction in COPD patients.Methods:Choose stable patients with COPD from the Department of Geriatrics,First Hospital of Shanxi Medical University from December 2017 to April 2018,and collect patients'history of disease and general information.Meanwhile,measure gradient pace,grip strength,and use DXA test to calculate appendicular skeletal muscle mass(ASM)and skeletal muscle index(SMI).According to EWGSOP recommended Asian diagnostic criteria,part of patients with COPD diagnosed sarcopenia are divided into the sarcopenia group,and the others are divided into the non-sarcopenia group.The peripheral venous blood are centrifuged immediately.The plasma IL-6 and IL-10 concentrations are measured by the method of enzyme-linked immunosorbent assay(ELISA).Then organize all clinical and laboratory data to analyze the affect of inflammatory mediators and COPD-related factors on sarcopenia.Result:1.Comparison of general data of the study subjects:There are 73 subjects enrolling in the study,including 59 males and 14 females.According to the EWGSOP recommended Asian Diagnostic Criteria,73 subjects are divided into the sarcopenia group and non-sarcopenia group.The sarcopenia group include 28 patients,accounting for 39.2%of the total patients,and 45 patients are in non-sarcopenia group.Patients in the sarcopenia group have higher age(t=2.38,P=0.02),lower BMI(t=6.36,P<0.001),and longer smoking time(t=2.22,P=0.03).The difference is statistically significant.Factors such as gender,hypertension,arrhythmia,smoking,smoking grade,and drinking history are not significantly different between the two groups.2.Comparison of clinical indicators related to COPD,and IL-6,IL-10 concentrations:comparing with non-sarcopenia group,the ratio of FEV1/FVC in patients with myasthenia decreases(t=2.06,P=0.04),and the CAT score increases(?~2=4.72,P=0.03).Meanwhile,IL-6(t=2.78,P<0.01)and IL-10 concentrations(t=2.15,P=0.04)are significantly higher.The difference is statistically significant.Lower level of serum Albumin is important for the development of sarcopenia(t=4.19,P<0.001).3.Correlation analysis between serum IL-6,IL-10 concentration,COPD related indicators and muscle mass:age(r=-0.27,P=0.02),IL-6 concentration(r=-0.38,P<0.001),IL-10 concentration(r=-0.38,P<0.001)are negatively correlated with hypothyroidism index(SMI),pulmonary function index FEV1/FVC(r=0.32,P<0.01),FEV1%(r=0.29,P<0.001),BMI(r=0.76,P<0.001)and serum Alb concentration(r=0.47,P<0.001)are positively correlated with SMI.4.logistic analysis of IL-6 and IL-10 concentration and COPD related factors:age(OR=1.11,P=0.02),IL-6(OR=1.07,P=0.01),IL-10 concentration(OR=1.11,P<0.05)are risk factors for sarcopenia,and BMI(OR=0.54,P=0.001),Albumin content(OR=0.82,P=0.04)are protective factors which can prevent muscle loss.Conclusion:The plasma concentrations of IL-6 and IL-10 are significantly increased in patients with COPD and sarcopenia which are the independent risk factors of muscle loss.They are not only relate to the decrease of muscle's function,such as the grip strength,pace,but have adverse affect on the quality of daily life. |
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