Serum level of testosterone, dihydrotestosterone and IGF-1 during an acute exacerbation of COPD and their relationships with inflammatory and prognostic indices: a pilot study.
OBJECTIVE
Acute exacerbations (AECOPD) of negatively influence the natural history of chronic obstructive pulmonary (COPD) and they are related to muscle dysfunction. In this pathway hypogonadism could play a pivotal role. Our study wants to evaluate possible relationships among prognostic indexes of AECOPD, represented by Acute Physiology and Chronic Health Evaluation (APACHE) II, inflammation (serum amyloid A, SSA) and anabolic hormones, especially less studied steroids, like dihydrotestosterone (DHT) e free-testosterone (f-T).


METHODS
Twenty-four patients (17 males; age 75 ± 13 yrs) were studied. On admission and at discharge a blood sample for total testosterone (T), DHT, insulin like grow factor 1 (IGF-1) and Serum Amyloid A (SSA) was obtained. f-T was calculated using Vermeulen's formula.


RESULTS
Descriptive statistical analysis shows reduced of T values (1.85 ± 2.28 ng/mL), f-T (0.028 ± 0.030 ng/mL), DHT (0.18 ± 0.19 ng/mL) and IGF-1 (91.840 ± 74.19 pg/mL). Calculating tertile for Apache II and SSA and using them as cut off point, three categories were made and used in the analysis (SSA< 10 mg/mL; 10-160 mg/mL; > 160 mg/mL); (APACHE II ≤ 10; 11-12; > 12). Using this classification, an inverse correlation between SAA and T (P = 0.01), f-T (0.01), DHT (0.001) and IGF-1 (P = 0.05) was found. Data show the same inverse relationship between APACHE II tertiles on one hand and T (P = 0.01) and f-T (P = 0.02) on the other hand.


CONCLUSIONS
Our data confirm systemic effects of AECOPD and the role of endocrinological derangements, suggesting a possible mechanism explaining them.
Pulmonary Medicine Department Università Cattolica del Sacro Cuore, Rome, Italy - horatio1983@libero.it.
G M
GM
Corbo
A
A
Di Marco Berardino
A
A
Mancini
R
R
Inchingolo
A
A
Smargiassi
S
S
Raimondo
S
S
Valente
D018806:APACHE; D000368:Aged; D015415:Biomarkers / Q000097:blood; D013196:Dihydrotestosterone / Q000097:blood*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000150:complications; D007249:Inflammation / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D010865:Pilot Projects; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood*; D012016:Reference Values; D000685:Serum Amyloid A Protein / Q000378:metabolism*; D013739:Testosterone / Q000097:blood*
D015415:Biomarkers; D000685:Serum Amyloid A Protein; D013196:Dihydrotestosterone; D013739:Testosterone; D007334:Insulin-Like Growth Factor I