Resistin as a Systemic Inflammation-Related Biomarker for Sarcopenia in Patients With Chronic Obstructive Pulmonary Disease

Abstract

BackgroundSarcopenia is common in patients with chronic obstructive pulmonary disease (COPD) and is mainly caused by systemic inflammation. Resistin acts as a proinflammatory cytokine and is involved in the activation of multiple inflammatory signaling pathways. The aim of this study was to determine the relationship between resistin levels and systemic inflammation and to assess the clinical value of circulating resistin for sarcopenia in patients with COPD.MethodsIn this prospective observational study, we enrolled 235 patients with COPD who were divided into development and validation sets. The definition of sarcopenia followed the guidelines from the Asian Working Group for Sarcopenia. Serum concentrations of resistin and TNF-α were measured using an enzyme-linked immunosorbent assay (ELISA).ResultsIn this study, higher serum resistin levels were significantly associated with lower skeletal muscle mass and muscular strength. The serum resistin levels in patients with sarcopenia were significantly higher than those in patients without sarcopenia. The serum resistin level had positive correlations with the serum TNF-α level (r = 0.250, p = 0.007). The predictive efficacy of the serum resistin level (AUC: 0.828) for sarcopenia was superior to that of the serum TNF-α level (AUC: 0.621). The cutoff point (7.138 ng/ml) for the serum resistin level was validated in the validation set (AUC: 0.818).ConclusionsSerum resistin levels were associated with systemic inflammation and can be used accurately and easily to predict sarcopenia in patients with COPD.

Pharmacological, Nutritional, and Rehabilitative Interventions to Improve the Complex Management of Osteoporosis in Patients with Chronic Obstructive Pulmonary Disease: A Narrative Review

“…In addition, sarcopenia is a complex and highly disabling condition that might affect about 15–55% of patients with COPD [ 30 ]. Interestingly, several risk factors have been identified to have a role in sarcopenia onset in people with COPD, including alcohol consumption, cigarette smoking, low physical activity levels, poor diet, and older age [ 29 , 31 ].…”

“…However, there is still a large gap of knowledge about the role of single risk factors in osteoporosis development in patients with COPD. Moreover, most of the studies currently available assessed multiple associations of factors to have a role in osteoporosis development since the difficulties in isolating single factors [ 17 , 22 , 24 , 30 ]. On the other hand, a specific assessment of the most important contributors to osteoporosis development should be mandatory to set up a personalized multitarget intervention aiming at preventing osteoporosis and maintaining bone health.…”

Osteosarcopenia in Patients with Chronic Obstructive Pulmonary Diseases: Which Pathophysiologic Implications for Rehabilitation?

“…In addition, frailty syndrome is commonly characterized by unintended weight loss, self-reported exhaustion, muscle weakness, slow walking speed, and low physical activity, worsening both physical and physiologic functions and significantly affecting HR-QoL and sanitary costs related to medical treatment and assistance [ 16 ]. Interestingly, growing evidence has highlighted the strict bond between frailty syndrome and sarcopenia [ 17 ] that affects about 15–55% of COPD patients [ 18 ]. To date, sarcopenia might also be considered an independent risk factor for fragility fractures due to diminished physical performance [ 4 ], with consequent crucial implications for balance impairment and an increased risk of falls [ 19 ].…”

“…In this scenario, about 38% of patients with COPD might be affected by osteoporosis, which is frequently associated with sarcopenia because both these pathological conditions share several risk factors [ 26 ] and molecular pathways [ 27 , 28 ]. Bone muscle crosstalk has been recently identified in regulating tropism of both these tissues through several molecular pathways, including IGF-1, sclerostin, myostatin, irisin, myonectin, mitochondrial dysfunction, and inflammatory cytokines [ 18 , 29 , 30 ]. In addition, the high prevalence of sarcopenia in patients with osteoporosis highlight this close connection, which goes beyond the sole mechanical stimuli and has a negative impact on both muscle and bone quality and density [ 20 , 31 ].…”

A systematic review and meta-analysis of the association between sarcopenia and myocardial infarction

“…Despite the fact that these two diseases were commonly confused, they are two distinct diseases [ 37 ]. It should be highlighted that sarcopenia and frailty are reported to be associated with chronic diseases [ 38 ] (e.g., chronic obstructive pulmonary disease [COPD] [ 39 ] and osteoporosis [ 40 ]), a high occurrence of polypharmacy [ 41 , 42 ] and adverse events as falls and poor QoL [ 7 , 8 , 43 ].…”