Аdipokine regulation and endothelial dysfunction in patients with chronic obstructive pulmonary disease and different bone mineral density

The objective of this study was to investigate serum levels of leptin, adiponectin and endothelin1 and to search their role in development of osteo
porosis in chronic obstructive pulmonary disease (COPD) patients.

Methods. Lung function, body mass index (BMI), bone mineral density (BMD)
of the lumbar spine and the femoral neck, and serum concentrations of leptin, adiponectin and endothelin1 were measured in 126 patients with COPD diagnosed according to GOLD and in 86 healthy subjects.

Results. Among COPD patients, 43% had osteoporosis, 34% had osteopenia and 23% had normal BMD. Osteopenia was diagnosed in 35% of controls. The mean BMD value in stage 2 COPD patients corresponded to osteope nia; in stage 3 and IV COPD patients corresponded to osteoporosis. Generally, BMD correlated with FEV1 (r = 0.38, p < 0.05 for the lumbar spine; r = 0.43, p < 0.05 for the femoral neck) and with pCO2 (r = –0.46, p < 0.05 and r = –0.39, p < 0.05, respectively) in COPD patients. No significant difference was found for leptin and adiponectin concentrations between stages 1 and 2 COPD patients and controls. Leptin level decreased and adiponectin level increased in stages 3 and 4 COPD patients compared to controls (p < 0.05). There was a direct relationship between BMI and leptin (r = 0.64; p < 0.001) and an inverse relationship between BMI and adiponectin (r = –0.51; p < 0.01). FEV1 and DLCO were related to leptin only (p < 0.001). Leptin was directly related to the femoral neck and the lumbar spine BMDs (r = 0.66, p < 0.001 and r = 0.49, p < 0.05, respectively), while adiponectin was inversely related to BMD (r = –0.43, p <0.05 for the femoral neck; r = –0.49, p <0.001 for the lumbar spine). We found inverse relationships between endothelin1 and the lumbar spine BMD (r = –0.51, p <0.01), leptin (r = –0.46, p < 0.05), FEV1 (r = –0.43, p < 0.05) and PO2 (r = –0.54, p < 0.05) and direct relationships between endothelin1 and pCO2 (r = 0.68, p < 0.001) and adiponectin (r = 0.51, p < 0.05). A relationship between endothelin1 and adipokines was found only in osteoporotic COPD patients.

Conclusion. Our results suggest that serum adipokines and endothelin1 are involved in the pathogenesis of respiratory failure and bone density loss in COPD patients. The most pronounced changes in concentration of these biomarkers and close relationships between them and BMD were observed in patients with osteoporosis.

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