Abstract
Background. The natural history of idiopathic pulmonary fibrosis (IPF) is very complex and unpredictable. Some patients will experience acute exacerbation (AE) and fatal outcomes. Methods. The study included 30 AE-IPF patients, 32 stable IPF (S-IPF) patients, and 12 healthy controls. We measured the plasma concentrations of leptin and KL-6. Simple correlation was used to assess associations between leptin and other variables. Plasma leptin levels were compared between AE-IPF and S-IPF subjects, decedents, and survivors. Kaplan-Meier curves were used to display survival and Cox proportional hazards regression was used to examine risk factors for survival. Results. In subjects with AE-IPF, plasma leptin was significantly greater than in subjects with S-IPF (p = 0.0003) or healthy controls (p < 0.0001). Plasma leptin was correlated with BMI, KL-6, LDH, CRP, and PaO2/FiO2 (p = 0.007; p = 0.005; p = 0.003; p = 0.033; and p = 0.032, resp.). Plasma leptin was significantly greater in 33 decedents than in the 23 survivors (p = 0.007). Multivariate Cox regression analysis showed leptin (>13.79 ng/mL) was an independent predictor of survival (p = 0.004). Conclusions. Leptin could be a promising plasma biomarker of AE-IPF occurrence and predictor of survival in IPF patients.
Highlights
The natural history of idiopathic pulmonary fibrosis (IPF) is characterized by decreasing pulmonary function over time
The study sample consisted of 62 patients with IPF (30 with acute exacerbation (AE)-IPF and 32 with stable IPF (S-IPF)) and 12 healthy controls evaluated at Nanjing Drum Tower Hospital, Nanjing, University Medical School from October 2009 to September 2014
Plasma Level of Leptin Was Elevated in AE-IPF Patients
Summary
The natural history of idiopathic pulmonary fibrosis (IPF) is characterized by decreasing pulmonary function over time. Leptin was first discovered and cloned by Zhang et al in 1994 [9] It is a versatile 16 kDa peptide hormone product of the Obese (OB) gene, and its main function is to regulate energy balance [9, 10]. Plasma leptin levels were compared between AE-IPF and S-IPF subjects, decedents, and survivors. In subjects with AE-IPF, plasma leptin was significantly greater than in subjects with S-IPF (p = 0.0003) or healthy controls (p < 0.0001). Plasma leptin was significantly greater in 33 decedents than in the 23 survivors (p = 0.007). Leptin could be a promising plasma biomarker of AE-IPF occurrence and predictor of survival in IPF patients
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