老年慢性阻塞性肺疾病患者营养状况及血清甲状腺素和瘦素表达变化及其相关性分析

Analysis of Nutritional Status and Serum Thyroid Hormone and Leptin Expression in Elderly Patients with Chronic Obstructive Pulmonary Disease and Their Correlation

目的:探讨老年慢性阻塞性肺疾病(COPD)患者的营养状况以及血清甲状腺素、瘦素水平变化,并分析其相关性。方法:选择我院2015年6月至2017年12月收治的64例老年COPD患者作为研究对象,按照营养状态分为营养不良组(34例)和非营养不良组(30例)两组,并选择同期来院检查的32例健康人作为对照组,比较三组患者的营养状况以及血清甲状腺素、瘦素水平,并分析血清瘦素水平与营养状况以及血清甲状腺素的相关性。结果:营养不良组患者的体重、体质量(BMI)、血清清蛋白(ALB)、血红蛋白(Hb)、肩胛下皮褶厚度(SSF)、三头肌皮褶厚度(TSF)、上臂周径(MAC)、上臂肌围长(MAMC)、理想体质量百分比(IBW%)营养状态指标以及血清瘦素、三碘甲状腺原氨酸(T3)、四碘甲状腺原氨酸(T4)、促甲状腺素(TSH)水平明显低于对照组和非营养不良组,差异具有统计学意义(P<0.05),而非营养不良组和对照组两组患者的各项营养状态指标差异无统计学意义(P>0.05)。老年COPD患者血清瘦素与BMI、TSF、MAC、IBW%营养指标以及血清TSH水平呈正相关(P<0.05)。结论:营养不良的老年COPD患者的血清瘦素以及甲状腺素水平明显降低,瘦素与COPD患者相关营养状态指标以及TSH呈正相关,与甲状腺素通过下丘脑-垂体-甲状腺轴,共同参与机体能量代谢、体质量以及饮食的调节。

Objective: To investigate the nutritional status and serum thyroid hormone and leptin levels in elderly patients with chronic obstructive pulmonary disease(COPD), and to analyze their correlation. Methods: Sixty-four elderly patients with COPD, who were admitted to Wuhan Hanyang Hospital Affiliated to Wuhan University of Science and Technology from June 2015 to December2017 were chosen as study subjects. According to nutritional status, the patients were divided into malnutrition group(34 cases) and non-malnutrition group(30 cases). In the same period, 32 healthy elderly individuals, who came to the hospital for examination, were chosen as control group. The nutritional status and serum thyroid hormone and leptin levels in the three groups were compared. The correlation among serum leptin levels, nutritional status, and serum thyroxine levels was also analyzed. Results: The body weight, BMI,ALB, HB, SSF, TSF, MAC, MAMC, IBW% nutritional status indicators and serum leptin, T3, T4, and TSH levels in the malnourished group were significantly lower than those in the control group and the non-malnutrition group, the difference was statistically significant(P<0.05). There was no significant difference in the nutritional status indicators between the non-malnutrition group and the control group(P>0.05). Serum leptin levels in elderly COPD patients were positively correlated with BMI, TSF, MAC, IBW% nutritional indicators,and serum TSH levels(P<0.05). Conclusions: Serum leptin and thyroxine levels are significantly reduced in elderly patients with COPD with malnutrition, and leptin is positively correlated with nutritional status indicators and TSH. It interacts with thyroxine through the hypothalamus-pituitary-thyroid axis and participates in the regulation of body energy metabolism, body weight, and diet.