الفهرس 
o Chronic Obstructive Pulmonary Disease (COPDOnly 14 pages are availabe for public view
 |  | from | 201 |  |  |
| | | from | 201 | | |
Abstract
COPD is defined as a preventable and treatable disease with some significant extra pulmonary effects that may contribute to the severity in individual patients. Its pulmonary component is characterized by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gases.
The adipose tissue is an important contributor to systemic manifestations of COPD. Indeed the inflammatory/anti inflammatory effects of adipokines highlight the fact that adipose tissue is more than energy storage organ.
Adiponectin is a protein specifically secreted from adipose tissue. It circulates to influence other organs as the liver, skeletal muscles, and blood vessels. An auto/paracrine effect on adipose tissue also exists. It has antidiabetic (by promoting insulin sensitivity), anti-inflammatory and anti-atherogenic effects. Its secretion is influenced by different hormones and cytokines. Hypoadiponectinemia is observed in obesity, type 2 diabetes, hypertension, coronary artery disease and bronchial asthma.
Although systemic manifestations as a result of low grade systemic inflammatory process are recognized by many researchers there is little knowledge on the alteration of adiponectin in COPD patients.
The present study was conducted in Chest Department, Ain shams University Hospital in the period between July 2012 and July 2013.
The aim of this work was to assess the levels of serum adiponectin in chronic Obstructive Pulmonary Disease patients (COPD) during acute exacerbation and in stable conditions.
This study included 95 subjects. 60 patients with stable COPD (20 mild, 20 moderate and 20 severe) .20 patients during exacerbation and 15 age related healthy subject as a control.
All subjects were submitted to:
- Full history taking
- Complete physical examination(General & Local)
- Plain chest x-ray P-A view
- Complete blood count, Erythrocyte sedimentation rate
- Liver and Kidney function tests
- Fasting and Post prandial blood sugar
- ECG
- Arterial blood gases analysis (ABG)
- Spirometry
- Estimation of adiponectin in serum by ELISA
Exclusion criteria included:
• Patients with concomitant diseases such as malignancy, infection other than respiratory tract infections,
• Patients with cardiac failure,
• Patients with endocrine disorder,
• Patients with hepatic or renal diseases,
• Patients with systemic autoimmune or connective tissue disorders.
• patients with recent surgery and patients on regular systemic corticosteroids.
The results were tabulated and statistically analyzed:
It was found that:
- Serum level of adiponectin (mcg/ml) is highly significant in COPD patients during exacerbation(1.69±0.39 mcg/ml) than that in control subjects (0.21±0.06 mcg/ml), (P<0.001).
- Serum level of adiponectin (mcg/ml) is highly significant in patients with stable COPD(0.80±0.45 mcg/ml) than that in control subjects (0.21±0.06 mcg/ml), (P<0.001).
- Serum level of adiponectin (mcg/ml) is highly significant during COPD exacerbation(1.69±0.39 mcg/ml) than that in stable cases (0.80 ±0.45 mcg/ml), (P<0.001).
- Serum level of adiponectin (mcg/ml) is highly significantly different between mild, moderate and severe grades of stable COPD cases. Adiponectin in Severe stages were significantly higher (1.26±0.36 mcg/ml) than moderate grades (0.74±0.31 mcg/ml) and moderate grades were significantly higher than mild grades (0.41±0.14 mcg/ml) (P<0.001).
- There was no significant correlation between changes in serum level of adiponectin (mcg/ml) and changes in FEV1 (%pred) and FEV1/FVC in stable COPD cases.There is also no significant correlation between changes in serum level of adiponectin (mcg/ml) and changes in FEV1 (% pred) and FEV1/FVC in COPD cases during exacerbation.