慢性阻塞性肺疾病患者血清内脂素与TNF-α及营养参数的相关性

Circulating visfatin level and its relation with TNF-α and nutritional status in patients with chronic obstructive pulmonary diseases

目的探讨慢性阻塞性肺疾病(COPD)患者血清内脂素与炎性反应因子TNF-α、营养状况的关系。方法稳定期COPD患者45例作为病例组,另选择健康体检者20例作为健康对照组。酶联免疫吸附法检测血清内脂素、TNF-α水平,测定多个营养参数,比较2组间血清内脂素、TNF-α水平及各营养参数间的差异,Pearson相关法分析内脂素与TNF-α以及各营养参数的相关性,并以多参数指数评分系统(MNI)评价2组的营养状态。结果 COPD组患者血清内脂素、TNF-α水平显著高于健康对照组(P<0.05),%IBW、MAMC低于健康对照组(P<0.05)。COPD患者血清内脂素水平与TNF-α水平呈显著正相关(r=0.73,P<0.05),与%IBW、TSF、MAMC、CHI、Alb、Palb无明显相关性(r依次=0.27,0.14,0.22,0.24,0.28,0.17,P均>0.05)。据MNI评价营养状况,COPD组46.7%(21例)发生了营养不良,健康对照组无营养不良发生。COPD营养不良亚组与COPD营养正常亚组间内脂素水平差异无统计学意义(P>0.05),但均显著高于健康对照组(P<0.05)。结论 COPD患者血清内脂素水平增高,并且与TNF-α呈正相关,与各营养参数无明显相关性。在COPD中内脂素可能是一种促炎脂肪细胞因子。

Objective To detect relation among visfatin levels,TNF-αand nutritional parameters in patients with chronic obstructive pulmonary diseases（COPD）.Methods Serum visfatin,TNF-α,and nutritional parameters（%IBW、TSF、MAMC、CHI、Alb、Palb） were measured respectively in 46 patients with COPD and 20 healthy controls.All patients were clinically stable.Serum visfatin and TNF-αwere measured by enzyme linked immunosorbent assay.Relationship between serum visfatin and TNF-α,nutritional parameters were analyzed by Pearson correlation.MNI was used to evaluate the nutritional status of the 2 group.Results The levels of visfatin,TNF-αwere significantly higher in patients with COPD than those in healthy controls（P0.05 ）。%IBW、MAMC were significantly lower in patients with COPD than those in healthy controls（P0.05）。The visfatin level was positively correlated with TNF-α（r =0.73,P0.05）,and was not correlated with%IBW, TSF,MAMC,CHI,Alb,Palb in COPD group（（r =0.27,0.14,0.22,0.24,0.28,0.17 respectively,P0.05）.According to MNI,21 patients with COPD occurred malnutrition out of 45（46.7%）,but none occurred malnutrition in healthy control.The levels of visfatin in malnourished group and non-malnourished group were not significantly different（P0.05）, but were significantly higher than that in healthy control respectively（P0.05）.Conclusion Serum visfatin level increased in patients with COPD,and was significantly correlated with TNF-a,but was not correlated with nutritional porameters COPD group.Visfatin may be a new proinfiammation adipocytokine in COPD.