Effects of Ghrelin Treatment on Exercise Capacity in Underweight COPD Patients: a substudy of a multicenter, randomized, double-blind, placebo-controlled trial of ghrelin treatment

BMC Pulmonary Medicine

Kenji Kangawa¹  Masahide Mori²  Toru Hiraga²  Masaharu Motone²  Yoshitaka Tateishi²  Kenji Yoshimura²  Mari Miki²  Seigo Kitada²  Noritoshi Nagaya³  Ryoji Maekura²  Keisuke Miki² 

[1] Department of Biochemistry, National Cerebral and Cardiovascular Center Research Institute, Suita, Japan;Department of Internal medicine, National Hospital Organization Toneyama National Hospital, 5-1-1 Toneyama, Toyonaka, Osaka, 560-8552, Japan;Department of Regenerative Medicine, National Cerebral and Cardiovascular Center Research Institute, Suita, Japan

关键词: Underweight;    Sympathetic nerve activity;    Pulmonary rehabilitation;    Exercise;    Dyspnea;   

Others  :  1109834
DOI  :  10.1186/1471-2466-13-37

 received in 2013-01-08, accepted in 2013-05-29,  发布年份 2013

【 摘 要 】

Background

The aim of this substudy of the ghrelin treatment, multicenter, randomized, double-blind, placebo-controlled trial was to investigate the effects of ghrelin administration on exercise capacity and the underlying mechanisms in underweight patients with chronic obstructive pulmonary disease (COPD) using cardiopulmonary exercise testing.

Methods

Twenty underweight COPD patients were randomized to pulmonary rehabilitation with intravenous ghrelin (2 μg/kg, n = 10) or placebo (n = 10) twice daily for 3 weeks in a double-blind fashion. The primary outcome was changes in peak oxygen uptake View MathML">. Secondary outcomes included changes in exertional cardio-respiratory functions: O₂-pulse, physiologic dead space/tidal volume-ratio (V_D/V_T), ventilatory equivalent for oxygen View MathML">, and ventilatory equivalent for carbon dioxide View MathML">.

Results

With incremental exercise, at peak exercise, there was a significant difference in the mean difference (ghrelin minus placebo), i.e., treatment effect in: i) peak View MathML"> (1.2 mL/kg/min, 95% CI: 0.2-2.3 mL/kg/min, between-group p = 0.025); ii) View MathML"> (-4.2, 95% CI: -7.9 to -0.5, between-group p = 0.030); iii) View MathML"> (-4.1, 95% CI: -8.2 to -0.1, between-group p = 0.045); iv) V_D/V_T (-0.04, 95% CI: -0.08 to -0.00, between-group p = 0.041); and v) O₂-pulse (0.7 mL/beat, 95% CI: 0.3 to 1.2 mL/beat, between-group p = 0.003). Additionally, repeated-measures analysis of variance (ANOVA) indicated a significant time-course effect of ghrelin versus placebo in the peak View MathML"> (p = 0.025).

Conclusion

Ghrelin administration was associated with improved exertional capacity and improvements in ventilatory-cardiac parameters.

Trial registration

UMIN (University Hospital Medical Information Network in Japan) C000000061

【 授权许可】

   
2013 Miki et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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