title: Serum ghrelin and adiponectin levels are increased but serum leptin level is unchanged in low weight Chronic Obstructive Pulmonary Disease patients.
abstract: BACKGROUND
  Weight loss and muscle wasting are common features reported in COPD patients and they are all related with systemic inflammation. In this study, the relationship between pulmonary functions and inflammatory and metabolic parameters in low weight COPD patients were investigated.
  
  
  METHODS
  Fifty male COPD patients were grouped according to the Global Initiative for Chronic Obstructive Lung Disease criteria. Group 1: Mild-moderate COPD patients (n=18; with a mean age of 66.4 ± 9.2 yrs; body mass index (BMI):19.7 ± 1.5 kg/m(2)), group 2: Severe-very severe COPD patients (n=32; with a mean age of 65.9 ± 10.0 yrs; BMI:19.3 ± 1.6 kg/m(2)), group 3: Control group composed of healthy nonsmoking males (n=17; with a mean age of 50.2 ± 8.4 yrs; BMI:21.85 ± 1.5 kg/m(2)). Anthropometric parameters, serum levels of adiponectin (ApN), ghrelin, leptin, hsCRP, IL-6, IL-1β, IL-8, TNF-α and pulmonary functions were compared.
  
  
  RESULTS
  Adiponectin concentration was higher in group 1 (43.3 ± 28.6 ng/mL; p<0.05) and group 2 (59.9 ± 31.8 ng/mL; p<0.001) when compared with the control group (23.5 ± 13.6 ng/mL). Ghrelin concentrations were higher in COPD groups (1281.0 ± 1173.7 and 1840.0 ± 403.6 pg/mL; p<0.05) compared to the control subjects (554.0 ± 281.9 pg/mL). When the groups were compared, no significant difference was found for leptin, IL-1β, TNF-α, and IL-8. Interleukin-6 and hsCRP levels were higher in group 1 than in the control group. ApN was negatively correlated with BMI and FEV1. In all groups, FEV1 showed positive correlation with BMI, skinfold thicknesses, insulin and triglyceride; negative correlation with age, pack/years, HDL-Chol and ApN. Increased SHBG with decreased insulin level and HOMA-IR may indicate increased insulin sensitivity in COPD groups.
  
  
  CONCLUSIONS
  The anti-inflammatory effect of ApN and ghrelin is more evident in severe-very severe COPD patients.
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul, Turkey. Electronic address: akubatuzum@yahoo.com.
authors.forename: Ayse Kubat
authors.initials: AK
authors.lastname: Uzum
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Department of Pulmonary Diseases, Istanbul, Turkey. Electronic address: mertsoylumunevver@yahoo.com.
authors.forename: Munevver Mertsoylu
authors.initials: MM
authors.lastname: Aydin
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul, Turkey. Electronic address: tutuncuy@yahoo.com.
authors.forename: Yildiz
authors.initials: Y
authors.lastname: Tutuncu
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Department of Biochemistry, Istanbul, Turkey. Electronic address: beyomer@hotmail.com.
authors.forename: Beyhan
authors.initials: B
authors.lastname: Omer
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Department of Pulmonary Diseases, Istanbul, Turkey. Electronic address: kiyanesen@gmail.com.
authors.forename: Esen
authors.initials: E
authors.lastname: Kiyan
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul, Turkey. Electronic address: farukalagol@gmail.com.
authors.forename: Faruk
authors.initials: F
authors.lastname: Alagol
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood* / Q000150:complications; D012129:Respiratory Function Tests; D013851:Thinness / Q000097:blood* / Q000150:complications; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D052242:Adiponectin; D054439:Ghrelin; D053583:Interleukin-1beta; D015850:Interleukin-6; D020738:Leptin; D014409:Tumor Necrosis Factor-alpha
keywords: Adipokine; COPD; Cachexia; Inflammation; Pulmonary functions