Diet, absorption, and hormone studies in relation to body weight in obstructive airways disease.

Abstract

Sixteen male patients with stable chronic obstructive airways disease were separated into two groups of eight according to arterial carbon dioxide tensions. Hypercapnia was associated with lower arterial oxygen tensions, higher red cell volume, and increased weight, while normocapnic subjects were decidedly thin. The considerable difference in body weight between the two groups could not be explained by variation in calorie intake, and malabsorption was excluded as a cause of weight loss in the underweight subjects. Serum tri-iodothyronine, thyroxine, cortisol, and oestradiol concentrations were similar and normal in each group, but both groups had significantly low testosterone values as compared with controls, values in the hypercapnic being appreciably lower than in the normocapnic group. The adrenal androgen dehydroepiandrosterone was significantly high in the normocapnic group and low in the hypercapnic group compared with controls. Serum pituitary luteinising and follicle stimulating hormones were normal, but three hypercapnic individuals had high serum prolactin values. Early morning urinary aldosterone values were significantly higher in the hypercapnic than in the normocapnic group. Such hormone comparisons have not previously been made in subjects with chronic obstructive airways disease grouped according to arterial blood gas values, and it is concluded that major alterations in adrenal and testicular function may occur, possibly due to pituitary suppression from hypoxia. Such hormonal changes might in part account for the contrasting alterations in body habitus found in this condition.

Sex hormone alterations and systemic inflammation in chronic obstructive pulmonary disease

“…A dysfunctioning hypothalamic‐pituitary‐gonadal axis has been reported in COPD in previous studies (8–12). Moreover, a decreased response to administered gonadotrophin‐releasing hormone was detected in chronic airway diseases (13).…”

Persistent suppression of resting energy expenditure after acute hypoxia

“…However, in diseases with chronic hypoxic manifestation, data are conflicting. In chronic obstructive pulmonary disease, fT 3 , fT 4 , and thyrotropin were not found to be altered in most studies [25][26][27]. Only one group found that severe airway obstruction is associated with reduced basal and stimulated thyrotropin levels [28].…”

Gonadal function in men with chronic illness

“…Therapy with testosterone will always need to be carefully considered as there will always remain the potential for abuse by men wanting a cure for chronic fatigue and lack of energy or seeking their lost youth. Woolf et al, 1985Abnormal LH pulsatility Vogel et al, 1985Increased Wang et al, 1978a Semple et al, 1979Semple et al, , 1981 Lower in hypercapnic patients impaired response Oxygen may improve Aasebo et al, 1993 Asthma Lowered in prednisolone Elevated gonadotrophins Testosterone increased Reid et al, 1985Reid et al, , 1996 Gama et al, 1995 Epilepsy May be increased May be increased Toone et al, 1980, 1983 Reduced Increased Testosterone may Harper et al, 1972 improve bone mass Barreca et al, 1983Griggs et al, 1985a,b, 1989 Kennedy's syndrome Normal testosterone Increased Warner et al, 1992 DHT resistance…”

“…Patients with COAD have been found to have lower testosterone levels than controls. Serum LH and FSH were normal, and in view of the inappropriate gonadotrophin levels it was suggested that hypoxia led to pituitary suppression (Semple et al, 1979). Those patients who were also hypercapnic had significantly lower testosterone levels than those who were normocapnic.…”