TNF-α is associated with loss of lean body mass only in already cachectic COPD patients

Respiratory Research

Peter D Wagner²  Per S Bakke¹  Jon A Hardie⁴  Shinya Aoki³  Paloma Gil-Bernabe³  Corina D’Alessandro-Gabazza³  Esteban C Gabazza³  Tomas ML Eagan² 

[1] Section of Pulmonary Medicine, Institute of Medicine, University of Bergen, N-5021, Bergen, Norway;Division of Physiology, University of California San Diego, 9500 Gilman Drive, La Jolla, San Diego, CA, 92093, USA;Department of Immunology, Mie University School of Medicine, Edobashi 2-174, Tsu city, Mie, 514-8507, Japan;Institue of Medicine, Haraldsplass Diakonale Sykehus, University of Bergen, N-5009, Bergen, Norway

关键词: Cachexia;    COPD;    TNF-α;    Inflammation;   

Others  :  796712
DOI  :  10.1186/1465-9921-13-48

 received in 2012-04-11, accepted in 2012-06-08,  发布年份 2012

【 摘 要 】

Background

Systemic inflammation may contribute to cachexia in patients with chronic obstructive pulmonary disease (COPD). In this longitudinal study we assessed the association between circulating C-reactive protein (CRP), tumor necrosis factor (TNF)-α, interleukin (IL)-1ß, and IL-6 levels and subsequent loss of fat free mass and fat mass in more than 400 COPD patients over three years.

Methods

The patients, aged 40–76, GOLD stage II-IV, were enrolled in 2006/07, and followed annually. Fat free mass and fat mass indexes (FFMI & FMI) were calculated using bioelectrical impedance, and CRP, TNF-α, IL-1ß, and IL-6 were measured using enzyme immunoassays. Associations with mean change in FFMI and FMI of the four inflammatory plasma markers, sex, age, smoking, FEV₁, inhaled steroids, arterial hypoxemia, and Charlson comorbidity score were analyzed with linear mixed models.

Results

At baseline, only CRP was significantly (but weakly) associated with FFMI (r = 0.18, p < 0.01) and FMI (r = 0.27, p < 0.01). Univariately, higher age, lower FEV₁, and use of beta2-agonists were the only significant predictors of decline in FFMI, whereas smoking, hypoxemia, Charlson score, and use of inhaled steroids predicted increased loss in FMI. Multivariately, high levels of TNF-α (but not CRP, IL-1ß or IL-6) significantly predicted loss of FFMI, however only in patients with established cachexia at entry.

Conclusion

This study does not support the hypothesis that systemic inflammation is the cause of accelerated loss of fat free mass in COPD patients, but suggests a role for TNF-α in already cachectic COPD patients.

【 授权许可】

   
2012 Eagan et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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