Association of Plasma Adipokines with Chronic Obstructive Pulmonary Disease Severity and Progression

Abstract

Rationale: 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.Objectives: 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.Measurements and Main 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 FEV 1 (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 FEV 1 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.

Metabolic Disorder in Chronic Obstructive Pulmonary Disease (COPD) Patients: Towards a Personalized Approach Using Marine Drug Derivatives

“…Thus, the serum levels of adipokines are elevated in patients affected by COPD, independently of their smoking habit, and positively correlate with disease severity and ratio of exacerbation [33,34]. Moreover, high adiponectin levels and low leptin/adiponectin ratio are associated with annual forced expiratory volume in 1 s (FEV 1 ) decline [33].…”

The Fat Lady Sings Again

“…Higher plasma adiponectin levels have been repeatedly shown associated with CT-assessed emphysema [20,21]. Then again, 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 [21]. These data suggest a possible contribution of adipokines in the development of emphysema.…”

“…Because of their regulatory role in immune responses and their increased expression by bronchial epithelial cells and alveolar macrophages, their potential role in COPD-related pathophysiology has been put forward [19]. Higher plasma adiponectin levels have been repeatedly shown associated with CT-assessed emphysema [20,21]. Then again, 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 [21].…”

Combination therapy of inhaled steroids and long-acting beta2-agonists in asthma–COPD overlap syndrome

“…Volumetric CT scans were performed using 16-slice multi-detector CT scanners as previously described 14. The extent of emphysema (emphysema index) was estimated using the threshold technique quantifying the percentage ratio of low attenuation areas (an apparent X-ray attenuation value below −950 HU) to the corresponding lung areas 15.…”