慢性阻塞性肺病患者心血管事件发生率高与脂联素水平低有关

2007-08-02 00:00 来源:丁香园 作者:蓝色幻想 编译
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  纽约(路透社健康专栏)8月1日——日本研究人员在7月份的《Chest》杂志上报道,日本与西方国家慢性阻塞性肺病(COPD)患者心血管死亡率不同,可能与患者血浆脂联素水平存在差异有关。

  奈良医科大学Koichi Tomoda 博士的研究小组为了研究脂联素在COPD中的作用,对19名体重较轻的COPD患者(体重指数[BMI]<20)、12名正常体重的COPD患者和12名正常体重的对照进行了研究。结果发现,COPD患者体内的脂联素水平显著高于对照组,且与BMI呈负相关。即使体重正常的COPD患者,其体内的脂联素水平也大约是相同体重对照个体的两倍。

  研究小组还发现,在COPD患者中残气量和脂联素存在正相关关系。此外,患者血清肿瘤坏死因子α水平>5 pg/mL与脂联素水平也具有显著相关性。

  Tomoda博士认为,该数据为“COPD患者血脂联素水平升高可能与COPD患者体重下降有关”的假设提供了依据。他补充说:“脂联素是脂肪组织来源的特异性蛋白,具有抗炎和抗动脉粥样硬化作用。体重过轻的COPD患者体内循环脂联素水平升高可能会减少心血管事件的发生。虽然还需要进一步的研究,但对于西方国家的COPD患者来说,低脂联素水平可能与心血管事件发生率高有关。”

  在西方,大多数COPD患者都比较胖,常死于心血管疾病。但在日本,多数COPD患者非常瘦弱,这些患者的主要死亡原因不是心血管疾病,而是呼吸衰竭。

  Adiponectin May Moderate Cardiovascular Events in COPD

  By David Douglas

  NEW YORK (Reuters Health) Aug 01 - Differences in plasma adiponectin levels may contribute to differences in cardiovascular mortality seen in Japanese and Western COPD patients, Japanese researchers report in the July issue of Chest.

  "In the West," lead researcher Dr. Koichi Tomoda told Reuters Health, "most patients with COPD are obese and die of cardiovascular disease. However, in Japan most patients with COPD are cachetic, and the leading cause of mortality in these patients is not cardiovascular disease, but respiratory failure."

  Dr. Tomoda and colleagues at Nara Medical University, Kashihara note that adiponectin is an adipose tissue-derived specific protein that has anti-inflammatory as well as anti-atherosclerotic effects.

  To investigate what role this agent might play in COPD, the researchers studied 19 underweight COPD patients with a body mass index (BMI) of less than 20, 12 normal weight COPD patients and 12 normal weight controls.

  Adiponectin levels in the COPD patients were significantly higher than those in control subjects and inversely correlated with BMI.

  "Even in the normal-weight patients with COPD," say the investigators, "adiponectin levels were significantly higher than those in control subjects." In fact, they were about twice as high as in controls with a similar weight.

  The team also found that there was a positive correlation between residual volume and adiponectin in the COPD patients. However, no other respiratory parameters showed a significant correlation.

  In addition, in patients with tumor serum necrosis factor-alpha levels greater 5 pg/mL, there was a significant association with adiponectin levels.

  The data, the team point out, "provide the basis for speculation that the elevation of plasma adiponectin level may be linked to body weight loss in patients with COPD."

  In particular, continued Dr. Tomoda, "Our study suggested that elevated circulating adiponectin in underweight patients with COPD might reduce cardiovascular events."

  Further investigation is needed, he concluded, but in Western COPD patients, "hypoadiponectinemia may contribute to the high occurrence of cardiovascular events."

  Chest 2007;132:135-140.

  http://www.medscape.com/viewarticle/560788

编辑: ache

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