Insulin resistance and inflammation — a further systemic complication of COPD
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Chronic obstructive pulmonary disease (COPD) is associated with a continuous systemic inflammatory response. Furthermore, COPD is associated with an excess risk for cardiovascular disease and type II diabetes. Systemic inflammation in other populations is a factor in atherogenesis and has been associated with insulin resistance. We assessed the association between systemic inflammation and insulin resistance in non-hypoxaemic patients with COPD. Fasting plasma glucose, insulin and inflammatory mediators were measured in 56 patients and 29 healthy subjects. Body mass index (BMI) and height squared fat- and fat-free-mass index were similar between subject groups. Using homeostatic modelling techniques, mean (SD) insulin resistance was greater in the patients, 1.68 (2.58) and 1.13 (2.02) in healthy subjects, p= 0.032. Fasting plasma insulin was increased in patients while glucose was similar to that in healthy subjects. Patients had increased circulating inflammatory mediators. Insulin resistance was related to interleukin-6 (IL-6), r = 0.276, p= 0.039, and tumour necrosis factor a soluble receptor I, r = 0.351, p= 0.008. Both IL-6 and BMI were predictive variables of insulin resistance r2 = 0.288, p <0.05. We demonstrated greater insulin resistance in non-hypoxaemic patients with COPD compared with healthy subjects, which was related to systemic inflammation. This relationship may indicate a contributory factor in the excess risk of cardiovascular disease and type II diabetes in COPD.
COPD: Journal of Chronic Obstructive Pulmonary Disease
Bolton, C.E., Evans, M., Ionescu, A.A., Edwards, S.M., Morris, R.H.K., Dunseath, G., Luzio, S.D., Owens, D.R. and Shale, D.J. (2007) 'Insulin resistance and inflammation—a further systemic complication of COPD', COPD: Journal of Chronic Obstructive Pulmonary Disease, 4(2), pp.121-126.
This article was published in COPD: Journal of Chronic Obstructive Pulmonary Disease on 02 July 2009 (online), available at http://dx.doi.org/10.1080/15412550701341053
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