The relationship between adipokines, body composition, and bone density in men with chronic obstructive pulmonary disease

Figures & data

Table 1 General characteristics of the study population

Characteristic	(n = 23)
Age (years)	66 (8.7)
Caucasian, n (%)	23 (100)
Body mass index (kg/m^2)	26.4 (6.9)
FEV 1 (% of predicted)	32 (11)
History of smoking, n (%)	23 (100)
Current, n (%)	5 (22)
Pack-years	60.8 (22.3)
Home oxygen, n (%)	19 (83)
Pulmonary medications, n (%)
Inhaled corticosteroid	19 (79)
Long-acting inhaled B2-agonist	13 (57)
Long-acting inhaled anticholinergic	11 (43)
Total hip BMD T-score	−1.1 ± 1.1
Lumbar spine BMD T-score	−1.2 ± 1.2
Normal, n (%)a	5 (22)
Osteopenia, n (%)a	11 (48)
Osteoporosis, n (%)a	7 (30)

Notes: Values given as mean (SD) unless otherwise specified.

a World health Organization Criteria using dual-energy x-ray absorptiometry BMD T-scores.

Abbreviations: FEV₁, forced expiratory volume in one second; BMD, bone mineral density.

Table 2 Selected bivariate correlations with total hip and spine bone mineral density

Parameter	Total hip BMD		Spine BMD
	R	p	R	p
Adipokines
TNF-α (ng/mL)	0.014	0.95	−0.016	0.94
TNFR-1 (pg/mL)	0.216	0.32	−0.028	0.90
TNFR-2 (ng/mL)	0.233	0.28	0.073	0.74
Leptin (ng/mL)	0.616	0.002a	0.456	0.03
Adiponectin (ng/mL)	−0.531	0.009a	−0.426	0.04
Resistin (ng/mL)	0.225	0.30	−0.194	0.38
Body composition
Body mass index (kg/m^2)	0.600	0.003	0.483	0.02
Total fat (kg)	0.635	0.001	0.443	0.03
Total lean (kg)	0.633	0.001	0.579	0.004
Total body mass (kg)	0.690	0.0003a	0.564	0.005
Markers of bone turnover
Osteocalcin (ng/mL)	−0.161	0.46	−0.40	0.06
Urinary NTX (nmol BCE/mmol creatinine)	−0.302	0.16	−0.328	0.13
Hormones
Testosterone (ng/dL)	−0.265	0.57	−0.104	0.64
Estradiol (pg/mL)	0.184	0.40	0.293	0.17
25-OHD (ng/mL)	−0.232	0.29	−0.079	0.72
Lung function
FEV1 % P	0.405	0.06	0.329	0.13
DCLO % P	0.354	0.11	0.111	0.62
TGV % P	−0.541	0.009	−0.342	0.12
TLC % P	−0.555	0.007a	−0.360	0.10
RV % P	−0.490	0.02	−0.359	0.10

Notes:

a No correlations were seen between total hip BMD and TLC % P, leptin, and adiponectin after adjustment for total body mass with partial correlation analysis.

Abbreviations: BMD, bone mineral density; TNF, tumor necrosis factor; TNFR, tumor necrosis factor receptor; NTX, N-telopeptide; 25-OHD, 25-hydroxy vitamin D; FEV₁ % P, forced expiratory volume in one second percent predicted; DLCO % P, diffusion capacity of carbon monoxide percent predicted; TGV % P, thoracic gas volume percent predicted; TLC % P, total lung capacity percent predicted; RV % P, residual volume percent predicted.

Table 3 Selected bivariate correlations with serum leptin and adiponectin

Parameter	Leptin		Adiponectin
	R	p	R	p
Adipokines
Leptin (ng/mL)	–	–	−0.648	0.0008
Adiponectin (ng/mL)	−0.648	0.0008	–	–
Resistin (ng/mL)	0.268	0.22	−0.417	0.048
TNF-α (ng/mL)	0.038	0.86	−0.243	0.26
TNFR-1(pg/mL)	0.266	0.22	−0.552	0.006
TNFR-2 (ng/mL)	0.298	0.17	−0.557	0.006
Body composition
Body mass index (kg/m2)	0.800	<0.0001	−0.658	0.0006
Total fat (kg)	0.836	<0.0001	−0.629	0.001
Total lean (kg)	0.442	0.04	−0.319	0.14
Total body mass (kg)	0.7586	<0.0001	−0.601	0.002
Bone mineral density
Total body BMD (g/cm^2)	0.550	0.007	−0.462	0.03
Total hip BMD (g/cm^2)	0.616	0.002	−0.531	0.009
Lumbar spine BMD (gm/cm^2)	0.456	0.03	−0.426	0.04
Markers of bone turnover
Urinary NTX (nmol BCE/mmol creatinine)	−0.702	0.0002	0.463	0.03
Osteocalcin (ng/mL)	0.048	0.83	−0.004	0.99
Lung function
FEV1 % P	0.328	0.13	−0.387	0.07
DCLO % P	0.264	0.23	−0.266	0.23
TGV % P	−0.620	0.002	0.457	0.03
TLC % P	−0.561	0.007	0.444	0.04
RV % P	−0.552	0.008	0.357	0.10

Abbreviations: BMD, bone mineral density; TNF, tumor necrosis factor; TNFR, tumor necrosis factor receptor; NTX, N-telopeptide; FEV₁ % P, forced expiratory volume in one second percent predicted; DLCO % P, diffusion capacity of carbon monoxide percent predicted; TGV % P, thoracic gas volume percent predicted; TLC % P, total lung capacity percent predicted; RV % P, residual volume percent predicted.

Table 4 Characteristics of patients with and without osteoporosis

Characteristic	Osteoporosisa (n = 9)	No osteoporosisb (n = 14)
Age (years)	65.2 (10.8)	66.4 (6.5)
Body mass index (kg/m^2)	22.6 (4.2)	28.9 (7.2)c
History of smoking, n (%)	9 (100)	14 (100)
Current, n (%)	2 (22)	3 (21)
Pack-years	55 (27.7)	64.3 (18.4)
AECOPD (number/year)	1.3 (2.0)	0.6 (0.9)
Home oxygen, n (%)	8 (89)	11 (79)
Pulmonary medications, n (%)
Inhaled corticosteroid	6 (67)	12 (86)
Long-acting inhaled B2-agonist	5 (56)	8 (57)
Long-acting inhaled anticholinergic	4 (44)	6 (43)
Central DXA BMD T-scores
Total hip	−1.97 (0.56)	−0.49 (0.97)
Lumbar spine	−2.24 (1.04)	−0.54 (0.73)

Notes: Values given as mean (SD) unless otherwise specified.

a Based on dual-energy X-ray absorptiometry T-score or a history of osteoporotic fracture

b Based on dual-energy X-ray absorptiometry T-score

c P = 0.014.

Abbreviations: AECOPD, acute exacerbation chronic obstructive pulmonary disease; BMD, bone mineral density; DXA, dual-energy X-ray absorptiometry.

Table 5 Comparison of patients with and without osteoporosis

Parameter	Osteoporosisa (n = 9)	No osteoporosisb (n = 14)	p
Adipokines
Leptin (ng/ml)	3.8 (4.7)	9.8 (8.7)	0.046
Adiponectin (ng/mL)	8969.2 (8008)	3333.2 (1788.8)	0.069
Resistin (ng/mL)	14.9 (6.9)	14.1 (4.3)	0.76
TNF-α (ng/mL)	1.6 (0.4)	1.6 (0.3)	0.86
TNFR-1 (ng/mL)	1.2 (0.5)	1.2 (0.4)	0.99
TNFR-2 (ng/mL)	2.6 (1.0)	3.0 (1.1)	0.41
Body composition
Total body fat (kg)	15.6 (5.9)	28.2 (13.5)	0.007
Total body lean (kg)	47.1 (3.7)	55.6 (9.9)	0.009
Total body mass (kg)	64.8 (4.9)	86.4 (22.4)	0.008
Bone turnover markers
Urinary NTX (nmol BCE/mmol creatinine)	38.4 (17.8)	27.9 (15.9)	0.18
Osteocalcin (ng/mL)	5.3 (2.9)	3.8 (2.7)	0.28
Hormones
Testosterone (ng/dL)	340.2 (150.6)	319.9 (145.9)	0.75
Estradiol (pg/mL)	24.7 (12)	33.6 (19.0)	0.23
25-OHD (ng/mL)	28.8 (15.7)	23.9 (9.1)	0.42
Lung function
FEV1 % P	24.5 (7.9)	37 (10)	0.003
TGV % P	210.3 (45.1)	173.2 (41.5)	0.08
RV % P	258.5 (80)	194.2 (68.7)	0.08
TLC % P	131.5 (21.8)	112.5 (21.8)	0.07
DLCO % P	29.4 (10.2)	42.1 (16.2)	0.036

Notes: Values given as mean (SD).

a Based on dual-energy X-ray absorptiometry T-score or a history of osteoporotic fracture

b Based on dual-energy X-ray absorptiometry T-score.

Abbreviations: TNF, tumor necrosis factor; TNFR, tumor necrosis factor receptor; NTX, N-telopeptide; 25-OHD, 25-hydroxy vitamin D; FEV₁ % P, forced expiratory volume in one second percent predicted; DLCO % P, diffusion capacity of carbon monoxide percent predicted; TGV % P, thoracic gas volume percent predicted; TLC % P, total lung capacity percent predicted; RV % P, residual volume percent predicted.