Objective: Although protein-calorie malnutrition and associated weight loss have been demonstrated in chronic obstructive pulmonary disease (COPD), the reasons for weight loss, as well as the relation of weight loss with hormonal and inflammatory markers is not clear. Therefore, the present study aimed to investigate the reasons for weight loss in COPD patients and the relation of weight loss with hormonal/inflammatory markers and hyperinflation.Methods: The present study included 60 patients with stable COPD who were admitted to the Chest Diseases Outpatient Clinic and 20 healthy controls. The patients were divided into three groups according to their body mass index (BMI); Group 1: BMI <20 kg/m2, Group 2: BMI 20-25 kg/m2 and Group 3: BMI >25 kg/m2. The patients underwent pulmonary function testing and arterial blood gas analysis. Serum adiponectin, ghrelin, leptin, tumour necrosis factor (TNF) alpha, C-reactive protein (CRP), prealbumin and transferrin levels were measured. The results were evaluated by appropriate statistical methods.Results: Considering the patient groups together, leptin and ghrelin levels were found to be statistically significantly lower in the patient group (p=0.001 and p=0.003). Serum leptin level was found to be lower in Group 1 with a BMI <20 as compared to the other COPD patients and the control group (p<0.001). Adiponectin level was lower in the group with a BMI <20 as compared to the group with a BMI >25 (p=0.031). No statistically significant difference was determined between the patients with and without hyperinflation in terms of serum ghrelin, leptin, adiponectin, TNF-?, prealbumin and transferrin levels. Conclusion: Decreased serum ghrelin and leptin levels were associated with weight loss. However, no relation could be identified between hyperinflation and hormonal markers. It was thought that further studies are needed in order to reach a definite conclusion
Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstrutive Pulmonary Disease Revised 2011. Available from: URL: http:// www.goldcopd.org/uploads/users/files/GOLD2011_Summary.pdf
Laveneziana P, Palange P; ERS Research Seminar Faculty. Physical activity, nutritional status and systemic inflammation in COPD. Eur Respir J 2012; 40: 522-9. [CrossRef]
Barnes PJ, Celli BR. Systemic manifestations and comorbidities of COPD (Review). Eur Respir J 2009; 33: 1165-85. [CrossRef]
Agusti A, Soriano JB. COPD as a systemic disease. COPD 2008; 5: 133-8. [CrossRef]
Gan WQ, Man SFP, Senthilselvan A, Sin DD. Review and a Meta-Analysis dis- ease and systemic inflammation: a systematic association between chron- ic obstructive pulmonary disease. Thorax 2004; 59: 574-80.[CrossRef]
Kuznar-Kaminska B, Batura-Gabryel H, Brajer B, Kaminski J. Analysis of nutritional status disturbances in patients with chronic obstructive pul- monary disease. Pneumonol Allergol Pol 2008; 76: 327-33.
Schols AM, Soeters PB, Dingemans AM, Mostert R, Frantzen PJ, Wouters EF. Prevalence and characteristics of nutritional depletion in patients with stable chronic obstructive pulmonary disease eligible for pulmo- nary rehabilitation. Am Res Dis 1993; 147: 1151-6. [CrossRef]
Schols AM, Wouters EF. Nutritional abnormalities and supplementation in chronic obstructive pulmonary disease. Clin Chest Med 2000; 21: 753-62. [CrossRef]
Wagner PD. Possible mechanisms underlying the development of ca- chexia in COPD. Review. Eur Respir J 2008; 31: 492-501. [CrossRef]
Wagner J, Clausen JL, Coates A, Pedersen OF, Brusasco V, Burgos F, et al. ATS/ERS task force: standardization of the measurement of lung vol- umes. Eur Respir J 2005; 26: 511-22. [CrossRef]
Lago F, C Dieguez, Gómez-Reino J, Gualillo O. Adipokines as emerging mediators of immune response and inflammation. Nat Clin Rheumatol 2007; 3: 716-24. [CrossRef]
Luo FM, Liu XJ, Li SQ, Wang ZL, Liu CT, Yuan YM. Circulating ghrelin in pa- tients with chronic obstructive pulmonary disease. Nutrition 2005; 21: 793-8. [CrossRef]
Calikoglu M, Sahin G, Unlu A, Ozturk C, Tamer L, Ercan B, et al. Leptin and TNF-Alpha levels in patients with chronic obstructive pulmonary disease and their relationship to nutritional parameters. Respiration 2004; 71: 44-50.
Karakas S, Karadag F, Karul AB, Gurgey O, Gurel S, Guney E, et al. Circu- lating leptin and body composition in chronic obstructive pulmonary disease. İnt J Clin Pract 2005; 59: 1167-70. [CrossRef]
Eker S, Ayaz L, Tamer L, Ulubas B. Leptin, visfatin, insulin resistance, and body composition change in chronic obstructive pulmonary disease. Scand J Clin Lab Invest 2010; 70: 40-4. [CrossRef]
Itoh T, Nagaya N, Yoshikawa M, Fukuoka A, Takenaka H, Shimizu Y, et al. Ele- vated plasma ghrelin level in underweight patients with chronic obstructive pulmonary disease. Am J Respir Crit Med 2004; 170: 879-82. [CrossRef]
Özkan S, Çaylak E. Grelin ve biyokimyasal fonksiyonları. Türkiye Klinikleri Tıp Bilimleri Dergisi 2006; 26: 272-83.
Tomoda K, Yoshikawa M, Itoh T, Tamaki S, Fukuoka A, Komeda K, et al. Elevated plasma adiponectin in underweight patients with chronic ob- structive pulmonary disease. Chest 2007; 132: 135-40. [CrossRef]
Yang-Yi M, Sun-Tie Y. The role of serum leptin and tumor necrosis factor in malnutrition of male chronic obstructive pulmonary disease patients. Chin Med J 2006; 119: 628-33.
Garcia P, Sood A. Adiponectin in pulmonary disease and critically ill pa- tients. Curr Med Chem 2012; 19: 5493-500. [CrossRef]
Ali Assad N, Sood A. Leptin, adiponectin and pulmonary diseases. Bio- chimie 2012; 94: 2180-9. [CrossRef]