Downregulated level of insulin in COPD patients during AE; role beyond glucose control?

Abstract

Objective

The purpose of this study was to explore the insulin level in the serum of chronic obstructive pulmonary disease (COPD) patients during acute exacerbation (AE).

Methods

The study population consisted of 22 acute exacerbation chronic obstructive pulmonary disease (AECOPD) patients, 20 COPD patients and 20 healthy controls. Fasting blood glucose, insulin and serum lipid levels were measured. After the patients recovered from AE, the insulin and glucose levels were also analyzed.

Results

Insulin level, glucose level and homeostasis model assessment of insulin resistance (HOMA-IR) of AECOPD patients were higher than healthy controls (7.19±6.02 vs 3.28±1.09 μIU/mL, P<0.05, 126.61±50.92 vs 96.21±12.66 mg/dL, P<0.05, 2.66±2.72 vs 0.78±0.26, P<0.05). For stable COPD patients, the insulin level, glucose level and HOMA-IR were 6.52±2.56 μIU/mL, 95.58±11.44 mg/dL, and 1.52±0.53, respectively. The triglyceride (TG) level, total cholesterol (CHOL) level and low-density lipoprotein cholesterol (LDL-CHOL) level were decreased in AECOPD patients (0.78±0.33 vs 1.05±0.35 mmol/L, P<0.05, 3.88±0.72 vs 4.49±0.7 mmol/L, P<0.05, 2.01±0.59 vs 2.59±0.58 mmol/L, P<0.05). When the patients had recovered from AE, the insulin levels increased (10.67±6.22 vs 7.12±6.19 μIU/mL, P<0.05) and the glucose levels decreased (122.69±41.41 vs 134.08±53.19 mg/dL, P>0.05).

Conclusion

A high insulin level and a high HOMA-IR status in COPD patients were demonstrated. Downregulated levels of insulin during AE compared with the convalescent state were detected, while the variation in the glucose level was not as great as expected, indicating a potentially important role for insulin in AECOPD.

Keywords:

• COPD
• insulin
• acute exacerbation

Acknowledgments

This work was supported by the Zhejiang Provincial Natural Science Foundation of China (LY17H160007, LY16H010003). We thank Dr Brian Eyden (Manchester, UK) for assistance with English language expression.

Abbreviations list

COPD, chronic obstructive pulmonary disease; AE, acute exacerbation; IGFBP7, insulin-like growth factor binding protein 7; IGF1, insulin-like growth factor 1; TG, triglycerides; CHOL, total cholesterol; LDL-CHOL, low-density lipoprotein cholesterol; HDL-CHOL, high-density lipoprotein cholesterol; HOMA-IR, homeostasis model assessment of insulin resistance.

Author contributions

WR designed the experiments, collected the clinical data, and drafted the manuscript; CY analyzed the data; HZ, SW, and XJ collected the serum samples; LS and ZX collected clinical data; KY conceived and designed the experiments. All authors contributed to data analysis, drafting and revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.