Abstract
anorexia. Leptin, a 167 amino-acid protein synthesized and secreted by white adipose tissue, is a component of a lipostatic signaling pathway that alters energy balance by central and peripheral mechanisms. In this study, the authors investigated the relationship of plasma leptin to both inflammation and energy balance in COPD patients (27 with emphysema and 15 with chronic bronchitis as classified by high-resolution CT). They employed both a cross-sectional and cohort prospective design. In the cross-sectional study, the relationship between the concentrations of plasma leptin and soluble tumor necrosis factor receptors 55 and 75 was examined. A significant correlation was found between leptin and tumor necrosis factor receptor 55 levels in patients with emphysema but not in patients with chronic bronchitis. In the prospective study, an inverse relationship between plasma leptin levels, baseline dietary intake, and response to nutritional therapy was reported. These results indicate leptin levels may be influenced by circulating cytokines, and that circulating leptin levels may, in turn, alter the patients’ ability to respond to nutritional intervention.
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