男性慢性阻塞性肺疾病炎性因子肌肉抑制素与体重指数FEV_1占预计值百分比的关系

Relations of serum myostatin and inflammatory factors with BMI and FEV_1/predicted in chronic obstructive pulmonary disease

目的研究稳定期慢性阻塞性肺疾病(慢阻肺)患者血清中炎性因子、肌肉抑制素、第一秒用力呼气容积占预计值的百分比(FEV1%pred)、体重指数(BMI)情况及相关性。方法选择2010-2012年重庆市稳定期慢阻肺男性患者及年龄相仿的健康者,用酶联免疫吸附法测定血清肿瘤坏死因子(TNF)-α、白介素(IL)-6、肌肉抑制素;肺功能仪器检测每位受试者的FEV1%pred;测定身高及体重,计算BMI。慢阻肺患者分别根据FEV1%pred及BMI分组,比较慢阻肺患者与健康受试者相关指标,探讨血清炎症因子、FEV1%预计值与肌肉抑制素的相关性。结果根据FEV1%pred及BMI分组(F组/T组)的慢阻肺组患者血清中TNF-α、IL-6及肌肉抑制素水平较对照组均有升高,除F1组/T1组外,差异有统计学意义(P<0.01),肺功能越差,BMI越低,TNF-α、IL-6及肌肉抑制素水平越高(P<0.05)。TNF-α、IL-6与肌肉抑制素正相关(P<0.05),FEV1%pred与肌肉抑制素负相关(P<0.05)。结论慢阻肺患者肺功能越差,BMI越低者,炎性因子及肌肉抑制素水平越高;炎性因子水平越高者,肌肉抑制素水平越高;肌肉抑制素水平越高者,反应肌肉萎缩越严重,肺功能越差,病情越重。炎性因子及肌肉抑制素可能成为慢阻肺患者潜在治疗的靶点。

Objective To study the relation of serum myostatin and inflammatory factor with BMI and FEV1/predicted in male patients with chronic obstructive pulmonary disease. Methods A cohort of outpatients with stable COPD and health volunteers were evaluated.We evaluated interleukin-6（IL-6）,tumor necrosis factor-α（TNF-α）,myostatin,FEV1%pred and body mass index（BMI）, and stratified for FEV1/pred and BMI.Plasma concentrations of IL-6,TNF-α and myostatin were measured by high sensitivity ELISA. Results The concentrations of TNF-α,IL-6 and myostatin increased significantly in different groups except for F1/B1 group as compared with control group（P〈0.001）.When stratified for FEV1%predicted or BMI,serum myostatin levels were correlated inversely with FEV1/predicted（P〈0.05）;there was a positive correlation between myostatin and TNF-α/IL-6 in serum（P〈0.05）. Conclusion Patients with lower FEV1/pred value have a lower BMI and higher inflammatory factor and higher myostatin level.Patients with a higher inflammatory factor level had a higher myostatin levels.Patients with higher myostatin levels（significantly more muscle atrophy）have a lower FEV1/pred value,incident with worse pathogenetic condition.Inflammatory factors and myostatin may become potential treatment target in COPD.