Adiponectin is associated with dynamic hyperinflation and a favourable response to inhaled glucocorticoids in patients with COPD

Abstract

Adipokines are mediators first described as products of adipose tissue regulating energy metabolism, but later known to be involved in many immune and inflammatory processes. Recently, adipokines have been found to modulate inflammation and smooth muscle cell responses in COPD. We investigated the association of adipokines adiponectin and leptin, with the degree of emphysema, pulmonary function, symptoms and glucocorticoid responsiveness in COPD patients.

Plasma adiponectin and leptin levels, spirometry, body plethysmography and symptoms were measured in 43 male COPD patients with smoking history ≥ 20 pack-years, post bronchodilator FEV₁/FVC<0.7 and pulmonary emphysema on HRCT. The measurements were repeated in a subgroup of patients after 4 weeks´ treatment with inhaled fluticasone.

In patients with COPD, adiponectin levels correlated positively with Raw (r=0.362, p=0.019) and FRC (r=0.355, p=0.046). The baseline adiponectin correlated negatively with the fluticasone induced changes in SGRQ symptom score (r=-0.413,p=0.040) and in FRC % pred (r=-0428,p=0.003), i.e. higher baseline adiponectin was associated with more pronounced alleviation of symptoms and dynamic hyperinflation. Leptin levels were not related to the measures of lung function, symptoms or glucocorticoid responsiveness.

Plasma adiponectin levels were associated with peripheral airway obstruction and dynamic hyperinflation in patients with COPD. A higher adiponectin level predicted more favourable relief of symptoms and hyperinflation during glucocorticoid treatment. Adiponectin may have a role in the COPD pathogenesis; it may also be a biomarker of disease severity and treatment response.