Leptin, visfatin, insulin resistance, and body composition change in chronic obstructive pulmonary disease

Eker, Suzan; Ayaz, Lokman; Tamer, Lülüfer; Ulubaş, Bahar

doi:10.3109/00365510903484063

Cited by 22 publications

(29 citation statements)

References 17 publications

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“…In addition, plasma leptin levels in COPD patients were correlated with BMI, lean body mass, FEV 1 and IC. Similar to our results, Eker et al (15) as well found leptin levels to be lower in the COPD group versus the control group, and determined a positive correlation between leptin levels and BMI. These results suggest that leptin levels are lower in patients with progressive airway obstruction, and decreased inspiratory capacity in other words with enhanced hyperinflation, and that decreased plasma leptin levels might be Table 4.…”

Section: Discussionsupporting

confidence: 93%

The Relation of Weight Loss with Hyperinflation, Serum Adiponectin, Ghrelin and Leptin Levels in Chronic Obstructive Pulmonary Disease

Cingözler¹,

Özge²,

Tamer³

et al. 2014

Eurasian J Pulmonol

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Objective: Although protein-calorie malnutrition and associated weight loss have been demonstrated in chronic obstructive pulmonary disease (COPD), the reasons for weight loss, as well as the relation of weight loss with hormonal and inflammatory markers is not clear. Therefore, the present study aimed to investigate the reasons for weight loss in COPD patients and the relation of weight loss with hormonal/inflammatory markers and hyperinflation.Methods: The present study included 60 patients with stable COPD who were admitted to the Chest Diseases Outpatient Clinic and 20 healthy controls. The patients were divided into three groups according to their body mass index (BMI); Group 1: BMI <20 kg/m 2 , Group 2: BMI 20-25 kg/m 2 and Group 3: BMI >25 kg/m 2 . The patients underwent pulmonary function testing and arterial blood gas analysis. Serum adiponectin, ghrelin, leptin, tumour necrosis factor (TNF) alpha, C-reactive protein (CRP), prealbumin and transferrin levels were measured. The results were evaluated by appropriate statistical methods.Results: Considering the patient groups together, leptin and ghrelin levels were found to be statistically significantly lower in the patient group (p=0.001 and p=0.003). Serum leptin level was found to be lower in Group 1 with a BMI <20 as compared to the other COPD patients and the control group (p<0.001). Adiponectin level was lower in the group with a BMI <20 as compared to the group with a BMI >25 (p=0.031). No statistically significant difference was determined between the patients with and without hyperinflation in terms of serum ghrelin, leptin, adiponectin, TNF-α, prealbumin and transferrin levels. Conclusion:Decreased serum ghrelin and leptin levels were associated with weight loss. However, no relation could be identified between hyperinflation and hormonal markers. It was thought that further studies are needed in order to reach a definite conclusion.

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Section: Discussionsupporting

confidence: 93%

The Relation of Weight Loss with Hyperinflation, Serum Adiponectin, Ghrelin and Leptin Levels in Chronic Obstructive Pulmonary Disease

Cingözler¹,

Özge²,

Tamer³

et al. 2014

Eurasian J Pulmonol

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“…Many recent studies have reported the relationship between leptin and local or systemic inflammation. Some studies [16,17,18,19,20] suggested that leptin may play an important role in the mechanism of weight loss in COPD patients and might be a potential biomarker to reflect the clinical status of COPD.…”

Section: Introductionmentioning

confidence: 99%

Circulating Leptin Concentrations in Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Zhou

Yuan

Zhang³

et al. 2013

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Background: Weight loss is a clinically important risk factor indicating a poor prognosis in chronic obstructive pulmonary disease (COPD). Leptin is an important regulator of food intake and energy expenditure. Objectives: To conduct a meta-analysis to determine whether the level of leptin is related to the disease status of COPD. Methods: Studies published before December 2012 were identified by searching PubMed, Embase and the Cochrane Database. Observational studies comparing circulating leptin levels between COPD patients and healthy controls were included. Data were independently extracted by two investigators and analyzed using Stata 12.0 software. Results: Ten articles were included in the meta-analysis. Circulating leptin levels were correlated with the body mass index (BMI) as well as percent fat mass in stable COPD patients. The correlation coefficient tended to be weaker during exacerbation. A positive correlation between leptin and tumor necrosis factor (TNF)-α levels was found in COPD exacerbations, while it disappeared in patients with stable disease. Most studies indicated that circulating leptin levels in stable COPD patients were not significantly different from those in healthy controls when adjusted for gender and BMI, whilst leptin levels tended to elevate in exacerbation groups. Conclusions: The normal regulatory mechanism of leptin is maintained in stable COPD patients despite weight loss. The additional correlation between leptin and TNF-α during exacerbations may support the closer association of leptin with changes in nutritional parameters and suggests its valuable role in the evaluation of systemic inflammatory responses in COPD patients during exacerbation, which merits further study.

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“…Reduced energy turnover may be exacerbated by reduced insulin sensitivity in COPD [6]; insulin driving cellular glucose uptake via the GLUT-4 receptor [7]. Understanding mechanisms underlying these changes may lead to treatments to improve exercise capacity in patients with COPD.…”

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confidence: 99%

Pathways associated with reduced quadriceps oxidative fibres and endurance in COPD

et al. 2012

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Reduced quadriceps endurance in chronic obstructive pulmonary disease (COPD) is associated with a predominance of type II glycolytic fibres over type I oxidative fibres (fibre shift) and reduced muscle energy stores. The molecular mechanisms responsible for this remain unknown. We hypothesised that expression of known regulators of type I fibres and energy production in quadriceps muscle would differ in COPD patients with and without fibre shift.We measured lung function, physical activity, exercise performance, quadriceps strength and endurance (nonvolitionally) in 38 Global Initiative for Chronic Obstructive Lung Disease stage I-IV COPD patients and 23 healthy age-matched controls. Participants underwent a quadriceps biopsy: type I and II fibre proportions were determined using immunohistochemistry and fibre shift defined using published reference ranges. Calcineurin A, phosphorylated AMP kinase (phospho-AMPK)-a, protein kinase A-a catalytic subunits, modulators of calcineurin activity and calmodulin, 14-3-3 proteins were measured by Western blotting, and myocyte-enriched calcineurin-interacting protein-1 mRNA measured by quantitative PCR. Downstream, nuclear myocyte enhancer factor-2 capable of DNA binding was quantified by transcription factor ELISA.Unexpectedly, calcineurin expression was higher, while phospho-AMPK was lower, in COPD patients with fibre shift compared to COPD patients without fibre shift. Phospho-AMPK levels correlated with quadriceps endurance in patients.Reduced phospho-AMPK may contribute to reduced quadriceps oxidative capacity and endurance in COPD.KEYWORDS: AMP kinase, calcineurin, myocyte enhancer factor-2, protein kinase A R educed quadriceps endurance is associated with exercise limitation in chronic obstructive pulmonary disease (COPD) [1]. Underlying the loss of endurance is a reduction in type I myosin and oxidative enzymes [2], the hallmarks of the reduced oxidative type I to glycolytic type II fibre ratio observed in the quadriceps of COPD patients, which we will refer to in this study as the presence of fibre shift [3]. Type I fibres rely exclusively on oxidative metabolism to generate ATP, type IIx fibres depend on glycolysis, and type IIa fibres utilise both oxidative and glycolytic metabolism [4]. Since oxidative metabolism generates several times more ATP than glycolysis per molecule of glucose [5], type I fibres are fatigue-resistant compared to type II fibres.COPD patients, with their fewer oxidative fibres, have fewer muscle energy stores and exhibit metabolic stress from ATP depletion at rest and at low workloads, unlike controls. Reduced energy turnover may be exacerbated by reduced insulin sensitivity in COPD [6]; insulin driving cellular glucose uptake via the GLUT-4 receptor [7]. Understanding mechanisms underlying these changes may lead to treatments to improve exercise capacity in patients with COPD.Pathways influencing muscle type I fibre differentiation during development, muscle oxidative enzymes and energy production/glucose uptake have been descri...

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Leptin, visfatin, insulin resistance, and body composition change in chronic obstructive pulmonary disease

Abstract: These results may be earlier signs for further diseases that can emerge in the advanced stages in patients with COPD. Evaluating the patients not only with the pulmonary function and also systemically, contributes to minimizing the mortality and morbidity.

Cited by 22 publications

References 17 publications

The Relation of Weight Loss with Hyperinflation, Serum Adiponectin, Ghrelin and Leptin Levels in Chronic Obstructive Pulmonary Disease

The Relation of Weight Loss with Hyperinflation, Serum Adiponectin, Ghrelin and Leptin Levels in Chronic Obstructive Pulmonary Disease

Circulating Leptin Concentrations in Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Pathways associated with reduced quadriceps oxidative fibres and endurance in COPD

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