Associated loss of fat-free mass and bone mineral density in chronic obstructive pulmonary disease
Associated loss of fat-free mass and bone mineral density in chronic obstructive pulmonary disease
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DOI：
10.1164/rccm.200406-754oc
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发表时间：
2004-12-15
影响因子：
24.7
通讯作者：
Shale, DJ
中科院分区：
文献类型：
--
作者：
Bolton, CE;Ionescu, AA;Shale, DJ
我们推测，在慢性阻塞性肺疾病患者中，脱脂物质丢失(FFM)和骨密度丢失(BMD)与(1)彼此相关，可能是临床上看不到的；(2)尿细胞和骨胶原蛋白降解的标志物；(3)肺部疾病的严重程度。对81例患者和38例健康受试者进行双能X线骨密度仪测定身体成分和骨密度。尿蛋白分解标志物、炎症介质及其可溶性受体。下定决心。33名患者的脱脂体重指数(kg/m(2))较低，其中17名患者的体重指数正常。32%的患者(13%的健康受试者)在髋部或腰椎患有骨质疏松症。细胞蛋白分解的标记物在患者中升高，并与肺部疾病严重程度和身体成分有关。骨质疏松症患者骨胶原降解的标记物较大。炎症介质在患者中升高。在慢性阻塞性肺疾病患者中，FFM丢失和BMD丢失是相关的、常见的，也可能是亚临床的。在严重的肺部疾病中，两者的损失都是最大的。低FFM和BMD患者细胞和骨胶原蛋白分解产物的排泄增加表明这些患者处于蛋白质分解代谢状态。
We hypothesized that in patients with chronic obstructive pulmonary disease, loss of fat-free mass (FFM) and loss of bone mineral density (BMD) were related to (1) each other and may be clinically inapparent, (2) urinary markers of cellular and bone Collagen protein breakdown, and (3) severity of lung disease. Eight-one patients and 38 healthy subjects underwent dual-energy X-ray absorptiometry to determine body composition and BMD. Urinary protein breakdown markers, inflammatory mediators, and their soluble receptors were. determined. Thirty-three patients had a low fat-free mass index (kg/m(2)), 17 of whom had a normal body mass index. Thirty-two percent of patients (13% of healthy subjects) had osteoporosis at the hip or lumbar spine. The marker of cellular protein breakdown was elevated in patients and related to lung disease severity and body composition. The marker of bone Collagen breakdown was greater in patients with osteoporosis. Inflammatory mediators were elevated in patients. Loss of FFM and loss of BMD were related, occurred commonly, and could be subclinical in patients with chronic obstructive pulmonary disease. Loss of both was greatest with severe lung disease. Increased excretion of cellular and bone Collagen protein breakdown products in those with low FFM and BMD indicates a protein catabolic state in these patients.