title: Association of plasma adipokines with chronic obstructive pulmonary disease severity and progression.
abstract: BACKGROUND
  Two adipokines, leptin and adiponectin, regulate metabolic and inflammatory systems reciprocally. The role of adiponectin in chronic obstructive pulmonary disease (COPD) has been studied. However, there are few data evaluating the relationship of plasma leptin with COPD severity or progression.
  
  
  OBJECTIVE
  The objective of this study was to evaluate the relationship of leptin, adiponectin, and the leptin/adiponectin ratio with COPD severity and progression according to COPD phenotypes.
  
  
  METHODS
  Plasma leptin and adiponectin levels were measured in 196 subjects with COPD selected from the Korean Obstructive Lung Disease cohort. Using a linear regression model and mixed linear regression, we determined the relationship of plasma leptin and adiponectin levels and the leptin/adiponectin ratio to COPD severity and progression over 3 years.
  
  
  RESULTS
  The concentration of adiponectin in plasma positively correlated with percent emphysema on initial computed tomography (CT) (adjusted P = 0.022), whereas plasma leptin concentrations and the leptin/adiponectin ratio exhibited a significant inverse correlation with initial FEV1 (adjusted P = 0.013 for leptin and adjusted P = 0.041 for leptin/adiponectin ratio). Increased plasma leptin and leptin/adiponectin ratio were significantly associated with change in percent emphysema over 3 years (adjusted P = 0.037 for leptin and adjusted P = 0.029 for leptin/adiponectin ratio), whereas none of the adipokines demonstrated an association with FEV1 decline over the 3-year period.
  
  
  CONCLUSIONS
  Plasma adiponectin and leptin vary according to COPD phenotypes. Plasma leptin and the leptin/adiponectin ratio, but not adiponectin, were significantly associated with changes in CT-assessed emphysema, suggesting a potential role as a biomarker in emphysema progression in patients with COPD.
authors.affiliation: 1 Department of Pulmonary and Critical Care Medicine, Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul.
authors.forename: Yeon-Mok
authors.identifier: http://orcid.org/0000-0003-0116-4683
authors.initials: YM
authors.lastname: Oh
authors.affiliation: 2 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul.
authors.forename: Byeong-Ho
authors.identifier: http://orcid.org/0000-0002-3124-1718
authors.initials: BH
authors.lastname: Jeong
authors.affiliation: 3 Biostatistics Team, Samsung Biomedical Research Institute, Seoul.
authors.forename: Sook-Young
authors.initials: SY
authors.lastname: Woo
authors.affiliation: 2 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul.
authors.forename: Su-Young
authors.initials: SY
authors.lastname: Kim
authors.affiliation: 2 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul.
authors.forename: Hojoong
authors.identifier: http://orcid.org/0000-0001-9207-0433
authors.initials: H
authors.lastname: Kim
authors.affiliation: 4 Department of Internal Medicine, Bundang CHA Medical Center, CHA University College of Medicine, Seongnam.
authors.forename: Ji-Hyun
authors.identifier: http://orcid.org/0000-0002-8287-5470
authors.initials: JH
authors.lastname: Lee
authors.affiliation: 5 Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul.
authors.forename: Seong Yong
authors.identifier: http://orcid.org/0000-0001-8098-3622
authors.initials: SY
authors.lastname: Lim
authors.affiliation: 6 Department of Internal Medicine, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul.
authors.forename: Chin Kook
authors.identifier: http://orcid.org/0000-0003-4533-7937
authors.initials: CK
authors.lastname: Rhee
authors.affiliation: 7 Department of Internal Medicine, Konkuk University College of Medicine, Seoul.
authors.forename: Kwang Ha
authors.initials: KH
authors.lastname: Yoo
authors.affiliation: 8 Department of Internal Medicine, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul; and.
authors.forename: Jin Hwa
authors.identifier: http://orcid.org/0000-0003-0843-9862
authors.initials: JH
authors.lastname: Lee
authors.affiliation: 9 Department of Internal Medicine, Yeouido St. Mary's Hospital, Catholic University of Korea, Seoul, Korea; and.
authors.forename: Hyoung Kyu
authors.initials: HK
authors.lastname: Yoon
authors.affiliation: 10 Respiratory Division, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Don D
authors.initials: DD
authors.lastname: Sin
authors.affiliation: 1 Department of Pulmonary and Critical Care Medicine, Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul.
authors.forename: Sang-Do
authors.identifier: http://orcid.org/0000-0001-8189-4509
authors.initials: SD
authors.lastname: Lee
authors.affiliation: 4 Department of Internal Medicine, Bundang CHA Medical Center, CHA University College of Medicine, Seongnam.
authors.forename: Eun Kyung
authors.identifier: http://orcid.org/0000-0001-6239-1682
authors.initials: EK
authors.lastname: Kim
authors.affiliation: 2 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul.
authors.forename: Hye Yun
authors.identifier: http://orcid.org/0000-0002-5937-9671
authors.initials: HY
authors.lastname: Park
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D018450:Disease Progression; D004646:Emphysema / Q000150:complications*; D005260:Female; D006801:Humans; D020738:Leptin / Q000097:blood*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D056910:Republic of Korea; D012129:Respiratory Function Tests; D012720:Severity of Illness Index
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers; D020738:Leptin
keywords: adiponectin; chronic obstructive pulmonary disease; emphysema; leptin