Chest
Original ResearchAirway DiseasesEffects of Lung Volume Reduction Surgery for Emphysema on Glycolipidic Hormones*
Section snippets
Study Design and Populations
The study was a prospective nonrandomized trial of 33 consecutive male white patients with moderate-to-severe emphysema who were undergoing standard resectional videothoracoscopic LVRS12 (ie, the LVRS group). They were compared to 31 similar patients who were eligible for surgery during the same time frame but had undergone a standardized RR program twice during the year (ie, the RR group) after having denied their final consent to undergo the operation for personal reasons.
The study population
Baseline Intergroup Analysis
No significant differences in age, smoking history, disease severity, or medication use was found between emphysematous patients and healthy subjects (not shown). As expected, emphysematous patients had moderate-to-severe airway limitation with altered FEV1, residual volume, dyspnea index, 6-min walking test results, and St. George respiratory questionnaire findings, whereas healthy subjects had normal values. Body composition revealed a poorer nutritional status (mean body mass index, 22.4 ±
Discussion
In normal conditions, body composition and the glycolipidic metabolism are under a multihormonal control. Insulin, which is produced by pancreatic β cells, stimulates tissue glucose utilization, regulates fatty acid metabolism, and favors protein synthesis. In a state of insulin resistance, both muscle tissue and the liver are unable to utilize glucose as the energetic or deposit substrate and divert their metabolism to lipids. NEFAs are greatly available due to the concomitant increased lipid
Acknowledgment
We thank Dr. Giulia Musolino for her precious contribution in the editing of this manuscript.
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This research was supported by grants from Italian Ministry for University and Research Cofin (No. 9906274194-06 and 2001061191-001), National Council for Research grant CU0100935CT26 2002, and by the Centro di Eccellenza 2001. This study has been carried out within the Research Fellowship Program “Tecnologie e Terapie Avanzate in Chirurgia” awarded by the Tor Vergata University.
The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).