Relationship between Systemic Inflammatory Marker, Oxidative Stress and Body Mass Index in Stable COPD Patient

Hyun Seok Ham; Hae Young Lee; Seung Jun Lee; Yu Ji Cho; Yi Young Jung; Ho Cheol Kim; Jong Ryeal Hahm; Chan Hoo Park; Jong Deok Lee; Hyun Joon Sohn; Hee Shang Youn; Young Sil Hwang

doi:10.4046/trd.2006.61.4.330

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Ham, Lee, Lee, Cho, Jung, Kim, Hahm, Park, Lee, Sohn, Youn, and Hwang: Relationship between Systemic Inflammatory Marker, Oxidative Stress and Body Mass Index in Stable COPD Patient

Original Article

Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2006; 61(4): 330-338.

Published online: 31 October 2006

DOI: https://doi.org/10.4046/trd.2006.61.4.330

Relationship between Systemic Inflammatory Marker, Oxidative Stress and Body Mass Index in Stable COPD Patient

Hyun Seok Ham, M.D.¹, Hae Young Lee, M.D.¹, Seung Jun Lee, M.D.¹, Yu Ji Cho, M.D.¹, Yi Young Jung, M.D.¹, Ho Cheol Kim, M.D.^1,³, Jong Ryeal Hahm, M.D.^1,³, Chan Hoo Park, M.D.^2,³, Jong Deok Lee, M.D.^1,³, Hyun Joon Sohn, M.D.⁴, Hee Shang Youn, M.D.^2,³, Young Sil Hwang, M.D.^1,³

¹Department of Internal Medicine, Gyeongsang National University, Jinju, Korea.

²Department of Pediatrics, College of Medicine, Gyeongsang National University, Jinju, Korea.

³Gyeongsang Institute of Health Sciences, Gyeongsang National University, Jinju, Korea.

⁴Department of Anatomy, Medical School of Chungbuk National University, Chungju, Korea.

Address for correspondence: Ho Cheol Kim, M.D. Department of Internal Medicine, Gyeongsang National University Hospital 90, Chilam-dong, Jinju, Gyeongnam, 660-302, Korea. Phone: 055-750-8684, Fax: 055-758-9122, hochkim@gshp.gsnu.ac.kr

Received 7 July 2006 Accepted 15 September 2006

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 FEV₁. 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 F₂α 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 F₂α 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.

Keywords: COPD, Oxidative stress, Systemic inflammatory marker, BMI

Figures and Tables

Figure 1

Serum IL-6 and TNF-α in normal control and COPD patients. ^*p value>0.05 compared with normal control.

Figure 2

Serum 8-iso-prostaglandin F2α and carbonyl protein in normal control and COPD patients. ^*p value<0.05 compared with normal control.

Figure 3

FEV1(L) value according to BMI and its relation with BMI in COPD patients. There was significant correlation between FEV1 and BMI (p<0.05, r=0.42). ^*p value<0.05 compared with normal and higher BMI.

Figure 4

Difference of BMI according to severity of COPD. ^*P value<0.05 compared with moderate COPD.

Figure 5

Serum IL-6 and TNF-α according to BMI in COPD patients. ^*p value>0.05 compared with lower and higher BMI.

Figure 6

Serum 8-iso-prostaglandin F2α and carbonyl protein according to BMI in stable COPD patients. ^*p value>0.05 compared with normal and higher BMI.

Table 1

Clinical characteristics in COPD patients and normal control

^*p<0.05 compared with normal control

Table 2

Clinical characteristics in COPD patients according to body mass index(BMI)

^*p<0.05 compared with lower and normal BMI

Acknowledgment

This study was supported by Gyeongsang National University Hospital Research Funds in 2005.

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