Abstract
Background: COPD is associated with inflammation which leads to acute exacerbation and causes extra pulmonary manifestations of the diseases. Elevated levels of CRP, fibrinogen, leukocyte counts are inflammatory markers associated with COPD.
Adiponectin and leptin are biomarkers of inflammation which can be used to assess disease activity and severity in COPD patients.
Aims: To compare the adiponectin and leptin levels during acute exacerbation and remission in patients of COPD & correlate the levels with severity of disease.
Methods: It was a hospital based case control study conducted in VMMC and Safdarjung Hospital, New Delhi. It was conducted on 60 patients of COPD & 30 controls. Adiponectin & leptin levels were measured on admission and 7 days after discharge during remission. Severity of COPD was assessed by GOLD guidelines. Acute exacerbation was defined by Anthonisen criteria. Patients were considered to be in remission if they do not require increased doses of bronchodilator, antibiotics or steroids.
Result: Leptin levels were higher in cases than control on admission 21.12 v/s 4.96. Adiponectin levels were also higher in cases than control on admission 5.91 v/s 3.17. Leptin levels were higher on admission, during acute exacerbation 21.12 than on remission 10.91. Adiponectin levels were higher on remission 7.11 than on admission. L/A ratio was higher on admission 3.71 v/s remission 1.74. Adiponectin levels correlate negatively with FeV1/FVC with r value of -0.005 but the correlation was not statistically significant. Serum leptin levels also correlates negatively with FeV1/FVC r value -0.051 but was not significant statistically.
Conclusion: Adiponectin & leptin levels are raised in cases of COPD compared to controls. Leptin levels are higher during acute exacerbation than remission whereas adiponectin levels are higher during remission. Adiponectin & leptin levels correlate negatively with severity of COPD but the correlation is not statistically significant.
References
- Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet. 2012;380:2095-2128.
- Donaldson G, Hurst J, Smith C, Hubbard R, Wedzicha J. Increased Risk of Myocardial Infarction and Stroke Following Exacerbation of COPD. Chest. 2010;137:1091-1097.
- Sode BF, Dahl M, Nordestgaard BG. Myocardial infarction and other co-morbidities in patients with chronic obstructive pulmonary disease. Eur Heart J 2011;32:2365–75.
- Carolan BJ, Kim YI, Williams AA, Kechris K, Lutz S, Reisdorph N et al. The association of adiponectin with computed tomography phenotypes in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2013; 188:561–66.
- Tomoda K, Yoshikawa M, Itoh T, Tamaki S, Fukuoka A, Komeda K et al. Elevated circulating plasma adiponectin in underweight patients with COPD. Chest 2007; 132:135–40.
- Schols AM, Creutzberg EC, Buurman WA, Campfield LA, Saris WH, Wouters EF. Plasma leptin is related to proinflammatory status and dietary intake in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1999; 160:1220–6.
- Chan KH, Yeung SC, Yao TJ, Ip MS, Cheung AH, Chan-Yeung MM et al. Elevated plasma adiponectin levels in patients with chronic obstructive pulmonary disease. Int J Tuberc Lung Dis 2010; 14:1193–200.
- Yao C, Liu X, Tang Z. Prognostic role of neutrophil and ndash; lymphocyte ratio and platelet and ndash; lymphocyte ratio for hospital mortality in patients with AECOPD. International Journal of Chronic Obstructive Pulmonary Disease. 2017;:2285-2290.
- Karadeniz G, Aktoğu S, Erer O, Kır S, Doruk S, Demir M et al. Predictive value of platelet-to-lymphocyte ratio in exacerbation of chronic obstructive pulmonary disease. Biomarkers in Medicine. 2016;10:701-710.
- La Cava A, Alviggi C, Matarese G. Unraveling the multiple roles of leptin in inflammation and autoimmunity. J Mol Med 2004; 82:4–11.
- Ahmad Elsayed Mahmoud, Magdy Mohammed Omar, Nabil A. Abdelghaffar Hibah, Hisham Ali Issa. Leptin hormone in obese and non-obese stable and exacerbated cases of chronic obstructive pulmonary disease Egypt J Chest Dis Tuberc 2015; 64:557–56.
- Krommidas G, Kostikas K, Papatheodorou G, Koutsokera A, Gourgoulianis KI, Roussos C et al. Plasma leptin and adiponectin in COPD exacerbations: associations with inflammatory biomarkers. Respir Med 2010; 104:40–6.
Corresponding Author
Dr Adnan Khan
Postgraduate Resident, Department of General Medicine, VMMC & SJH