Relation between serum leptin,soluble tumor necrosis factor receptor and nutrition status in patients with chronic obstructive pulmonary disease

Objective To investigate the correlation between the serum leptin levels,soluble tumor necrosis factor receptor(sTNF-R55 and sTNF-R75) on nutrition state in the patients with chronic obstructive pulmonary disease(COPD),as well as to explore the pathogenesis.Methods Twenty-six COPD patients in acute exacerbations stage(group Ⅰ),twenty-seven COPD patients in stable stage(group Ⅱ) and twenty-six healthy controls were studied.Body height,body mass,body mass index(BMI),percentage of normal body mass(NM%),percentage of body fat(fat%),triceps skin-fold thickness(TSF),subscapular skin-fold thickness(SSF),abdominal skin-fold thickness(ASF),mid-upper arm circumference(MAC),mid-upper arm muscle circumference(MAMC),serum albumin(ALB),pro-albumin(pro-ALB),total lymphocyte counts(LYM) were determined.Serum leptin was measured by radioimmunoassay,plasma sTNF-R55 and sTNF-R75 were measured by enzyme-linked immunosorbent assay(ELISA) at the same time.The correlation between leptin and nutritional parameters as well as sTNF-R55 and sTNF-R75 was analysed.Results ① BMI,NM%,fat%,TSF,SSF,ASF,MAC,MAMC,ALB,pro-ALB and LYM in COPD patients were significantly lower than those in healthy controls(P(0.01)).② Serum leptin level was significantly higher in group Ⅰ [((6.86)±(2.56)) μg/L] than that in healthy controls [((3.99)±(1.19)) μg/L] and in group Ⅱ [((2.46)±(1.41)) μg/L](P(0.01));Serum leptin level was significantly lower in group Ⅱ than that in healthy controls(P(0.01)).Plasma sTNF-R55,sTNF-R75 were significantly higher in group Ⅰ [((2 401.89)±(358.36)) ng/L;((3 827.28)±(675.70)) ng/L] than those in healthy controls [((1 596.07)±(354.84)) ng/L],(P(0.01)).Plasma sTNF-R55,sTNF-R75 were significantly higher in group Ⅱ [((2 586.53)±(671.19)) ng/L;((3 710.52)±(705.04)) ng/L] than those in healthy controls,too [((1 596.07)±(354.84)) ng/L](P(0.01)).sTNF-R55 and sTNF-R75 were not significant between group Ⅰ and group Ⅱ(P(0.01)).③ Serum leptin in COPD group Ⅱ showed a positive correlation with nutritional parameters.Plasma sTNF-R55 and sTNF-R75 in COPD group Ⅱ showed a negative correlation with nutritional parameters.④ Serum leptin showed a negative correlation with sTNF-R55 and sTNF-R75 in group Ⅱ.sTNF-R55 showed a positive correlation with sTNF-R75.Conclusion Malnutrition occurred in patients with COPD.Serum leptin level,sTNF-R55 and sTNF-R75 correlate with nutritional parameters in COPD patients and may contribute to the malnutrition in COPD.