Plasma leptin is related to proinflammatory status and dietary intake in patients with chronic obstructive pulmonary disease

Am J Respir Crit Care Med. 1999 Oct;160(4):1220-6. doi: 10.1164/ajrccm.160.4.9811033.

Abstract

Chronic obstructive pulmonary disease (COPD) is a syndrome of chronic wasting, in part associated with a chronic inflammatory response. The aim of this study was to investigate cross-sectionally and prospectively the potential role of leptin in relation to systemic inflammation in the regulation of the energy balance in COPD. Body composition by deuterium dilution, resting energy expenditure (REE) by indirect calorimetry, and plasma concentrations of leptin and soluble tumor necrosis factor (TNF) receptors (sTNF-R) 55 and 75 by ELISA were measured in 27 male patients with emphysema and 15 male patients with chronic bronchitis (disease-subtype defined by high-resolution computed tomography [HRCT]). Emphysematous patients were characterized by a lower body mass index due to a lower fat mass (FM) (p = 0.001) and by lower mean (detectable) leptin concentrations (p = 0.020) compared with bronchitic patients. Leptin was exponentially related to FM in emphysema (r = 0.74, p < 0.001) and in chronic bronchitis (r = 0.80, p = 0.001). Furthermore, a significant partial correlation coefficient between leptin and sTNF-R55 adjusted for FM and oral corticosteroid use was seen in emphysema (r = 0.81, p < 0.001) but not in chronic bronchitis. In 17 predominantly emphysematous depleted male patients with COPD, baseline plasma leptin divided by FM was in addition logarithmically inversely related to baseline dietary intake (r = -0.50, p = 0.047) and to the degree of weight change after 8 wk of nutritional support (r = -0.60, p = 0.017). This proposed cytokine-leptin link in pulmonary cachexia may explain the poor response to nutritional support in some of the cachectic patients with COPD and may open a novel approach in combating this significant comorbidity in COPD. Schols AMWJ, Creutzberg EC, Buurman WA, Campfield LA, Saris WHM, Wouters EFM. Plasma leptin is related to proinflammatory status and dietary intake in patients with chronic obstructive pulmonary disease.

MeSH terms

  • Aged
  • Body Composition
  • Body Mass Index
  • Body Water
  • Bronchitis / blood
  • Bronchitis / pathology
  • Bronchitis / physiopathology
  • Calorimetry, Indirect
  • Chronic Disease
  • Cross-Sectional Studies
  • Diet*
  • Energy Metabolism
  • Humans
  • Leptin / blood*
  • Lung Diseases, Obstructive / blood*
  • Lung Diseases, Obstructive / pathology
  • Lung Diseases, Obstructive / physiopathology
  • Male
  • Nutritional Support
  • Prospective Studies
  • Pulmonary Emphysema / blood
  • Pulmonary Emphysema / pathology
  • Pulmonary Emphysema / physiopathology
  • Receptors, Leptin
  • Receptors, Tumor Necrosis Factor / blood*
  • Respiratory Mechanics

Substances

  • Leptin
  • Receptors, Leptin
  • Receptors, Tumor Necrosis Factor
  • leptin receptor, human