안정된 만성폐쇄성폐질환 환자에서 신체질량지수와 전신 염증인자, 산화 스트레스와의 관련성

Abstract

Background: The main factors associated with weight loss in patients with COPD are not well known. Since chronic inflammation and oxidative stress play a major pathogenic role in COPD, these factors may be responsible for the patients' weight loss. Therefore, this study measured the body mass index (BMI) in COPD patients and evaluated the variables, such as systemic inflammatory marker, oxidative stress and lung function, that correlate with the BMI. Method: The stable COPD patients (M:F=49:4, mean age=68.25±6.32) were divided into the lower (<18.5), normal (18.5-25) and higher (>25) BMI group. The severity of the airway obstruction was evaluated by measuring the FEV 1. The serum IL-6 and TNF-α levels were measured to determine the degree of systemic inflammation, and the carbonyl protein and 8-iso-prostaglandin F2α level was measured to determine the level of oxidative stress. Each value in the COPD patients and normal control was compared with the BMI. Results: 1) Serum 8-iso-prostaglandin F 2α in COPD patients was significantly higher (456.08±574.12 pg/ml) than that in normal control (264.74±143.15 pg/ml) (p<0.05). However, there were no significant differences in the serum IL-6, TNF-α, carbonyl protein between the COPD patients and normal controls. 2). In the COPD patients, the FEV1 of the lower BMI group was significantly lower (0.93±0.25L) than that of the normal BMI (1.34±0.52L) and higher BMI groups (1.72±0.41L) (p<0.05). The lower FEV1 was significantly associated with a lower BMI in COPD patients (p=0.002, r=0.42). The BMI of very severe COPD patients was significantly lower (19.8±2.57) than that of the patients with moderate COPD (22.6±3.14) (p<0.05). 3). There were no significant differences in the serum IL-6, TNF-α, carbonyl protein and 8-iso-prostaglandin F 2α according to the BMI in the COPD patients. Conclusion: The severity of the airway obstruction, not the systemic inflammatory markers and oxidative stress, might be associated with the BMI in stable COPD patients. Further study will be needed to determine the factors associated with the decrease in the BMI of COPD patients.