Effect of exacerbation frequency on body composition and serum ghrelin and adiponectin concentrations in patients with chronic obstructive pulmonary disease

INTRODUCTION Exacerbations affect the natural history of chronic obstructive pulmonary disease (COPD). OBJECTIVES The aim of the study was to evaluate the effect of exacerbation frequency in COPD on body composition and systemic inflammation assessed by the measurement of serum adiponectin and ghrelin concentrations. PATIENTS AND METHODS The study group included 152 patients with COPD. Body composition was assessed by bioimpedance. Fasting serum adiponectin and ghrelin concentrations were evaluated by enzyme-linked immunosorbent assays. RESULTS Of the 152 patients, 60 did not report any exacerbation in the last 12 months, 53 had 1 exacerbation, and 39 had more than 1 exacerbation. The mean number of exacerbations in the whole group was 1.04 +/- 1.3 per patient per year and increased with the increasing degree of airway obstruction. Patients with exacerbations had a lower fat-free mass (FFM) index, lower total body water, and lower resting metabolic rate compared with patients without exacerbations (18.3 +/- 2.5 kg/m(2) vs. 19.3 +/- 2.7 kg/m(2); 36.9 +/- 8.1 kg vs. 40.2 +/- 8.0 kg; and 1482.8 +/- 301.1 kcal vs. 1616.0 +/- 322.0 kcal; respectively). The adiponectin concentration was higher in patients with more than 1 exacerbation than in those with 1 or no exacerbations (14.5 +/- 8.6 mg/l vs. 11.2 +/- 7.6 mg/l, P < 0.05). We observed significant negative correlations between the number of exacerbations and the muscle mass index, FFM index, total body water, resting metabolic rate, and adiponectin concentration in the whole group. CONCLUSIONS Exacerbations affect body composition in patients with COPD. Patients with frequent exacerbations have more enhanced systemic inflammation. Assessment of the body composition and systemic inflammation should be part of the routine management of patients with COPD.