老年慢性阻塞性肺疾病稳定期患者血清瘦素水平与机体代谢的相互影响

目的 评价在老年慢性阻塞性肺病（chronic obstructive pulmonary disease， COPD）稳定期患者中，血清瘦素水平与身体消耗和能量代谢之间的相互作用。方法 纳入2009年6月至2011年6月在四川大学华西医院住院及门诊治疗≥60岁的COPD稳定期患者共92例为COPD组，同时在成都市社区纳入≥60岁的健康老年男性80例作为对照组，测定体质量指数（BMI）、脂肪含量、静息能量消耗、肺功能、血清瘦素和肿瘤坏死因子-α（TNF-α）水平，对两组人群的各项指标进行统计分析。结果 与对照组相比，COPD组患者男性和女性BMI均降低（P<0.05），血清瘦素水平亦降低（P=0.000），而两组间的静息能量消耗和炎性因子TNF-α差异并无统计学意义，矫正BMI和脂肪体质量百分比后，两组人群血清瘦素水平差异无统计学意义。而在老年COPD患者人群中，血清瘦素水平与BMI和脂肪含量呈正相关，与血清TNF-α水平无关。结论 老年COPD稳定期患者血清瘦素水平降低与体质量和脂肪含量下降有关，与TNF-α水平无关。

Relationship of Serum Leptin Level and Metabolism in Elderly People with Stable Chronic Obstructive Pulmonary Disease

Objective To investigate the correlation of serum leptin and to energy consumption and metabolization in the patients with chronic obstructive pulmonary disease (COPD). Methods We included 92 outpatients with stable COPD in West China Hospital of Sichuan University as trail group (COPD group) and 80 healthy elderly people in community as control group. All patients and healthy control received the measurements of body mass index (BMI), fat mass, resting energy expenditure （REE）, lung function, serum leptin and tumor necrosis factor-α （TNF-α）. Results The concentrations of serum leptin, BMI and lung function were lower in COPD group than those in control group （P<0.01）.The concentrations of serum leptin between two groups were not difference after the adjusted results of BMI and fat mass. There was no difference of REE and TNF-α concentrations in these two groups. The serum leptin had positive correlation with BMI and fat mass， but there were no correlation between of TNF-α and serum leptin. Conclusion In elderly people with stable COPD, the decline on the serum leptin is related to the decrease of BMI and fat mass, but barely related to the level of TNF-α.