• Department of Respiratory Medicine, The Third People’s Hospital of Chengdu, The Second Affiliated Medical School of Chengdu of Chongqing Medical University. Chengdu,Sichuan, 610031, ChinaCorresponding Author: LIU Chun-tao, E-mail: taosen666@ tom. com;
Chronic obstructive pulmonary disease; Insulin resistance; Interleukin-6; Tumor necrosis factor-α
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Objective  To investigate the clinical significance of insulin resistance ( IR) in chronic obstructive pulmonary disease ( COPD) .
Methods  Patients with stable COPD were recruited while healthy volunteers were enrolled as control. The diagnosis and severity assessment were made according to chronic obstructive pulmonary disease diagnosis and treatment guideline ( revised edition 2007) . Fasting serum levels of glucose ( FBG) , insulin ( FIN) , blood lipids, fibrinogen, C-reactive protein ( CRP) , tumor necrosis factor ( TNF-α) , and interleukin-6 ( IL-6) were measured. The degree of IR was calculated by IAI( IAI =1/FBG ×FIN) . The relationship of IR with COPD severity and above parameters was analyzed.
Results  A total of 121 subjects with COPD were enrolled in which 22 cases of mild COPD, 28 cases of moderate COPD,34 cases of severe COPD, and 37 cases of extremely severe COPD. The levels of FBG and FIN were significantly higher in the COPD group than those in the normal control group ( P  lt;0. 05) . ISI in the COPD patients was higher than that in the controls ( - 3. 88 ±0. 54 vs. - 3. 40 ±0. 28, P  lt;0. 05) . The levels of CRP, fibrinogen, TNF-α, and IL-6 were significantly higher in the COPD group than those in the control group ( P  lt;0. 05) . The levels of CRP, TNF-αand IL-6 increased progressively with the severity of COPD. There was a negative correlation between ISI and the severity of COPD ( r = - 0. 512, P  lt; 0. 01) , positive correlations of CRP, fibrinogen, TNF-αand IL-6 levels with COPD severity, respectively( r=0. 710, 0. 600,0. 708,0. 707, all P  lt;0. 01) , and negative correlations of ISI with the levels of CRP, fibrinogen, TNF-α and IL-6 ( r = - 0. 384, - 0. 240, - 0. 298, - 0. 396, all P  lt; 0. 01) , respectively.
Conclusion  There is an increase in fasting serum insulin and insulin resistance in patients with COPD compared with healthy subjects, which deteriorates with severity of COPD.

Citation： LI Yanwu,LIUChuntao,ZENG Xuefeng. The Correlation Between Chronic Obstructive Pulmonary Disease and Insulin Resistance. Chinese Journal of Respiratory and Critical Care Medicine, 2012, 11(5): 422-427. doi: Copy