KOAH HASTALARINDA LEPTÝN VE TNF ALFA DÜZEYLERÝ VE BUNLARIN NUTRÝSYONEL PARAMETRELERELE ÝLÝÞKÝSÝ

Amaç: Bu çalýþmada kilo kaybý olmayan stabil ve akut atakta olan KOAH hastalarýnda serum leptin ve TNF-? düzeylerini saptamayý ve nutrisyonel parametrelerle serum leptin, TNF alfa düzeyleri arasýndaki iliþki incelemeyi amaçladýk. Yöntem ve Gereç: 51 stabil KOAH, 14 akut atakta olan KOAH ve 18 kontrol hastasý çalýþmaya dahil edildi. BMI, triceps deri kývrým kalýnlýgý, serum albümin, leptin ve TNF-? düzeyleri hesaplandý. Leptin ve TNF-? düzeyi ELISA yöntemi ile ölçüldü. Bulgular: Leptin düzeyleri alevlenmesi olan KOAH hastalarýnda stabil ve kontrol grubuna göre anlamlý olarak yüksek bulundu. Ancak, akut alevlenme olan hastalarda leptin ve beslenme parametreleri arasýnda bir iliþki bulunmadý. Bu üç grup arasýnda TNF-? ile beslenme parametreleri arasýnda anlamlý iliþki yoktu. KOAH hastalarýnda ve kontrol grunbunda serum leptin ve TNF-? düzeyleri arasýnda korelasyon saptanmazken, Serum TNF-? düzeyi ile beslenme parametreleri arasýnda da bu üç grup arasýnda iliþki bulunmadý. Sonuç: TNF-? düzeyleri, yüksek serum leptin düzeyi ile iliþkili deðildi; KOAH akut atak hastalarýnýn sayýsýnýn az olmasý ve TNF- ? deðerlerinin sayýsal olarak hesaplanamamasý nedeniyle; TNF-? düzeyi ile yüksek serum leptin düzeyi arasýnda iliþki saptanmadý. Her ne kadar stabil KOAH hastalarýnda leptin ve nutrisyonel parametreler arasýnda korelasyon varken, akut atak olan KOAH hastalarýnda ve kontrol grupta yoktu. Bu nedenle, KOAH hastalarýnda enerji dengesinin düzenlenmesi sýrasýnda leptin ve TNF-? arasýnda anlamlý bir korelasyon saptanmadý.

LEPTIN AND TNF-ALPHA LEVELS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND THEIR RELATIONSHIP TO NUTRITIONAL PARAMETERS

Aim: This study aimed to detect serum leptin and TNF- ? levels in COPD patients without weight loss during stable disease and acute exacerbation, and to investigate relationships between leptin, TNF-? and nutritional parameters at different stages of the disease. Material and Methods: 51 stable COPD patients, 14 COPD patients with acute exacerbation and 18 control subjects participated in this study. To eliminate the effects of sex differences, all patients and controls were male. BMI, triceps of skinfold tickness and serum albumin and serum leptin and TNF-? levels were measured in all participants. Leptin and TNF-? levels were measured by ELISA. Results: Leptin levels were significantly higher in patients with exacerbation than in both stabledisease and control groups. Leptin levels were significantly correlated with the nutritional parameters in stable groups. However, in patients with acute exacerbation, a correlation between leptin and nutritional parameters was not found. There was no significant relationship between TNF-? and nutritional parameters in the three groups. While there was no correlation between serum TNF-? and leptin levels in COPD patients and control groups, Serum TNF-? levels did also not correlate with nutritional parameters in any of groups. Conclusion (1) circulating TNF-? levels were not associated with increased leptin levels and (2) because of the fewer number of the acute exacerbation of COPD patient and not calculated the value of TNF-alpha levels as a numeric value, we did not find elevated TNF-? levels in COPD patients with acute exacerbation (3) although leptin and nutritional parameters were correlated in the stable COPD patients, it was disappeared completely during an exacerbation and control groups. Therefore, there was no significant correlation between leptin and TNF-? during the regulation of the energy balance in COPD patients.