Relationship between nutrition state of chronic obstructive pulmonary disease patients and the plasma level of growth hormone releasing peptide
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摘要:
目的了解慢性阻塞性肺疾病(COPD)患者血浆生长素释放肽(Ghrelin)水平及其营养不良和疾病严重程度之间的关系。 方法采用放射免疫法测定80例稳定期COPD患者(分营养不良COPD组42例，非营养不良COPD组38例)及32例健康对照者血浆Ghrelin水平。酶联免疫吸附试验法测定肿瘤坏死因子-α、白细胞介素-1β，并测定身高体质量指数、三头肌皮肤皱厚度、上臂中部臂围、血清白蛋白。计算分析血浆Ghrelin水平与营养参数、细胞因子的关系。 结果营养不良COPD组血浆Ghrelin水平显著高于健康对照组及非营养不良COPD组(P<0.01)，营养不良COPD组细胞因子水平显著高于健康对照组及非营养不良COPD组（P<0.01）。血浆Ghrelin水平与绝大多数营养参数呈负相关（P<0.01）。血浆Ghrelin水平与细胞因子水平呈正相关。但无统计学意义（P>0.05）。 结论COPD患者Ghrelin水平升高；病情越重，营养状况越差，Ghrelin水平越高，炎症反应越严重。 Abstract:Objective To understand the relationship of patients with chronic obstructive pulmonary disease(COPD) between plasma Ghrelin level , degree of malnutrition and severity of disease. Methods Test plasma Ghrelin level of 80 COPD patients of stable stage were divided into malnutrition group 42 cases and normal nutrition group 38 cases and 32 healthy controllers were analysed by the method of radioimmunoassay. Enzyme-linked immunosorbent assay method was used to test tumor necrosis factor-1, Leukocyte interleukin-1, and bioelectrical impedance was used to test body adipose composition analysis. Body mass index, triceps skin fold thickness ,middle arm circumference and serum albumin were tested. The relationship of plasma Ghrelin level, nutrition and cytokines were analysed. Results The plasma Ghrelin of malnutrition COPD group was higher than that of normal nutrition group and healthy controls(P<0.01), so was to the cytokines level(P<0.01). The plasma Ghrelin level was negatively related to most nutritional index(P<0.01), and positively related to the level of cytokines without significant statistical meaning(P>0.05). Conclusions The higher level of Ghrelin of COPD patients, the more severe the patient was and the worse nutrition with more severer inflammation response. -
Key words:
- chronic obstructive pulmonary disease /
- ghrelin /
- malnutrition /
- TNF-1 /
- LI-1
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表 1 表1 两组COPD患者与对照组之间各项指标的比较（x±s）
指标 n BMI(kg/m2) 三头肌皮肤皱厚度(mm) 上臂中部臂围(cm) COPD组 80 21.80±3.1 12.89±5.64 24.12±4.55 营养不良COPD组 42 19.20±4.1*# 11.54±6.87*# 22.15±6.52*# 非营养不良COPD组 38 22.10±3.8 14.24±5.69 25.74±3 .71 健康对照组 32 23.14±2.7 15.38±4.82 26.51±6.19 *P<0.05 vs 健康对照组；#P<0.05 vs 非营养不良COPD组. 
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表 2 两组COPD患者与对照组之间炎症因子的比较
指标 n 白蛋白(g/L) 肿瘤坏死因子-α(pg/mL) 白细胞介索-lβ(pg/mL) 血浆总生长素 释放肽(pg/mL) COPD组 80 36.17±4.05 1.48±0.56 2.14±0.47 902.67 711. 49~1126.05 营养不良COPD组 42 30.00±4.34*# l.53±0.68*# 2.35±0.26*# l054.32*# 856.56~2 383.79 非营养不良COPD组 38 39.23±3.55 1.36±0.37* 1.97±0.25* 753.14 650.58~941 .37 健康对照组 32 41.39±5.47 1.25±0.11 1.76±0.53 784.45 676.92~956.45 *P<0.05 vs 健康对照组；#P<0.05 vs 非营养不良COPD组.
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表 3 血浆ghrelin浓度与营养参数TNF-α、IL-1β的相关分析
COPD组 健康对照组 r P r P BMI(kg/m2) -0.527 <0.01 0.027 >0.05 三头肌皮肤皱厚(mm) -0.468 <0.01 0.136 >0.05 上臂中部臂围(cm) -0.476 <0.0l 0.145 >0.05 白蛋白(g/L) -0.432 <0.01 0.023 >0.05 肿瘤坏死因子-α(pg/mL) 0.411 >0.05 0.051 >0.05 白细胞介索-lβ(pg/mL) 0.524 >0.05 0.109 >0.05
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表 4 两组COPD血浆9 hrelin浓度与营养参数TNF-α、IL-1β的相关分析
组别 营养不良COPD组 非营养不良COPD组 r P r P BMI(kg/m2) -0.524 <0.01 -0.516 <0.0l 三头肌皮肤皱厚(mm) -0.528 <0.01 -0.466 >0.05 上臂中部臂围(cm) -0.676 <0.01 -0.155 >0.05 白蛋白(g/L) -0.723 <0.01 -0.067 >0.05 肿瘤坏死因子-α(pg/mL) 0.471 >0.05 0.324 >0.05 白细胞介索-lβ(pg/mL) 0.536 >0.05 -0.509 >0.05
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