Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 5

Fat-free mass change after nutritional rehabilitation in weight losing COPD: role of insulin, C-reactive protein and tissue hypoxia

Authors Simonetta Baldi, Roberto Aquilani, Gian Domenico Pinna, et al

Published 17 February 2010 Volume 2010:5 Pages 29—39

DOI https://doi.org/10.2147/COPD.S7739

Review by Single-blind

Peer reviewer comments 3

Simonetta Baldi, Roberto Aquilani, Gian Domenico Pinna, Paolo Poggi, Angelo De Martini, Claudio Bruschi

Department of Pneumology and Biomedical Engineering, Scientific Institute of Montescano, Salvatore Maugeri Foundation I.R.C.C.S. Pavia, Italy

Background: Fat-free mass (FFM) depletion marks the imbalance between tissue protein synthesis and breakdown in chronic obstructive pulmonary disease (COPD). To date, the role of essential amino acid supplementation (EAAs) in FFM repletion has not been fully acknowledged. A pilot study was undertaken in patients attending pulmonary rehabilitation.

Methods: 28 COPD patients with dynamic weight loss > 5% over the last 6 months were randomized to receive EAAs embedded in a 12-week rehabilitation program (EAAs group n = 14), or to the same program without supplementation (C group n = 14). Primary outcome measures were changes in body weight and FFM, using dual X-ray absorptiometry (DEXA).

Results: At the 12th week, a body weight increment occurred in 92% and 15% of patients in the EAAs and C group, respectively, with an average increase of 3.8 ± 2.6 kg (P = 0.0002) and −0.1 ± 1.1 kg (P = 0.81), respectively. A FFM increment occurred in 69% and 15% of EAAs and C patients, respectively, with an average increase of 1.5 ± 2.6 kg (P = 0.05) and −0.1 ± 2.3 kg (P = 0.94), respectively. In the EAAs group, FFM change was significantly related to fasting insulin (r2 0.68, P < 0.0005), C-reactive protein (C-RP) (r2 = 0.46, P < 0.01), and oxygen extraction tension (PaO2x) (r2 = 0.46, P < 0.01) at end of treatment. These three variables were highly correlated in both groups (r > 0.7, P < 0.005 in all tests).

Conclusions: Changes in FFM promoted by EAAs are related to cellular energy and tissue oxygen availability in depleted COPD. Insulin, C-RP, and PaO2x must be regarded as clinical markers of an amino acid-stimulated signaling to FFM accretion.

Keywords: COPD, pulmonary rehabilitation, branched chain amino acids, insulin, systemic inflammation

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF] 

 

Other articles by this author:

Medicinal clays improve the endurance of loaded inspiratory muscles in COPD: a randomized clinical trial of nonpharmacological treatment

Baldi S, Pinna GD, Bruschi C, Caldara F, Maestri R, Dacosto E, Rezzani A, Popovich E, Bellinzona E, Crotti P, Montemartini S, Fracchia C

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:2235-2248

Published Date: 23 October 2015

The mediating role of cytokine IL-6 on the relationship of FEV1 upon 6-minute walk distance in chronic obstructive pulmonary disease

Baldi S, Jose PE, Bruschi C, Pinna GD, Maestri R, Rezzani A, Bellinzona E, Fracchia C, Dacosto E, Crotti P, Montemartini S

International Journal of Chronic Obstructive Pulmonary Disease 2014, 9:1091-1099

Published Date: 7 October 2014

C-reactive protein correlates with tissue oxygen availability in patients with stable COPD

Simonetta Baldi, Gian Domenico Pinna1 Piera Mombaruzzo, Milena Biglieri, Angelo De Martini, Paolo Palange

International Journal of Chronic Obstructive Pulmonary Disease 2008, 3:745-751

Published Date: 5 December 2008

Readers of this article also read:

Emerging and future therapies for hemophilia

Carr ME, Tortella BJ

Journal of Blood Medicine 2015, 6:245-255

Published Date: 3 September 2015

Molecular targets in arthritis and recent trends in nanotherapy

Roy K, Kanwar RK, Kanwar JR

International Journal of Nanomedicine 2015, 10:5407-5420

Published Date: 26 August 2015

Current perspectives in stem cell research for knee cartilage repair

Orth P, Rey-Rico A, Venkatesan JK, Madry H, Cucchiarini M

Stem Cells and Cloning: Advances and Applications 2014, 7:1-17

Published Date: 16 January 2014

Duloxetine in the management of chronic musculoskeletal pain

Smith HS, Smith EJ, Smith BR

Therapeutics and Clinical Risk Management 2012, 8:267-277

Published Date: 19 June 2012

Topical diclofenac in the treatment of osteoarthritis of the knee

Niklas Schuelert, Fiona A Russell, Jason J McDougall

Orthopedic Research and Reviews 2011, 3:1-8

Published Date: 6 February 2011

Crystallization after intravitreal ganciclovir injection

Pitipol Choopong, Nattaporn Tesavibul, Nattawut Rodanant

Clinical Ophthalmology 2010, 4:709-711

Published Date: 14 July 2010