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

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/m2, Group 2: BMI 20-25 kg/m2 and Group 3: BMI >25 kg/m2. 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.