Analysis of serum adiponectin and leptin in patients with acute exacerbation of idiopathic pulmonary fibrosis.
Noriyuki EnomotoYoshiyuki OyamaHideki YasuiMasato KarayamaHironao HozumiYuzo SuzukiMasato KonoKazuki FuruhashiTomoyuki FujisawaNaoki InuiYutaro NakamuraTakafumi SudaPublished in: Scientific reports (2019)
Weight loss progresses with the progression of idiopathic pulmonary fibrosis (IPF), and acute exacerbation of IPF (AE-IPF) frequently occurs in its advanced stage. Adiponectin and leptin are adipokines produced from adipose tissue, and are related to thinness and obesity, respectively. Additionally, these adipokines are implicated in the regulation of inflammation and fibrosis centering on peroxisome proliferator-activated receptor γ (PPARγ). However, the relationship between adiponectin/leptin and AE-IPF remains poorly known. We conducted this study to evaluate levels of serum adiponectin/leptin, and to elucidate the clinical importance of adiponectin and leptin in patients with AE-IPF. Thirty-two patients (39 episodes) who were diagnosed with AE-IPF at our hospital from 1997 to 2016 were retrospectively studied. Serum adiponectin and leptin concentrations were measured with enzyme-linked immunosorbent assay. Patients with AE-IPF showed higher levels of serum adiponectin and leptin than those at initial diagnosis of IPF (p = 0.007 and p = 0.027, respectively). Serum adiponectin/leptin (A/L) ratio was negatively correlated with body mass index at AE-IPF (r = -0.456, p = 0.003) and PaO2 before AE-IPF (r = -0.498, p = 0.034), and positively correlated with C-reactive protein at AE-IPF (r = 0.316, p = 0.049). Patients with higher A/L ratios had worse survival than those with lower A/L ratios (log-rank, p = 0.026). Further, in multivariate analysis, serum A/L ratio was a significant prognostic factor in patients with AE-IPF (HR 2.60, p = 0.042). In conclusion, the higher adiponectin/leptin ratio may be associated with a poor prognosis in patients with AE-IPF.
Keyphrases
- idiopathic pulmonary fibrosis
- insulin resistance
- metabolic syndrome
- interstitial lung disease
- adipose tissue
- poor prognosis
- weight loss
- body mass index
- prognostic factors
- type diabetes
- chronic obstructive pulmonary disease
- healthcare
- high fat diet
- oxidative stress
- long non coding rna
- skeletal muscle
- emergency department
- ejection fraction
- physical activity
- weight gain
- end stage renal disease
- intensive care unit
- high throughput
- respiratory failure
- high fat diet induced
- liver failure
- single cell