Article

Adipose tissue produces leptin, which is pro-inflammatory, and
adiponectin, which has anti-inflammatory properties. Participants with chronic
spinal cord injury (SCI) have increased body fat and are at increased risk for
respiratory illness. OBJECTIVE: To assess the associations between leptin and
adiponectin with pulmonary function in a chronic SCI cohort. DESIGN:
Cross-sectional study. SETTING: Veterans Affairs Medical Center. PARTICIPANTS: A
total of 285 participants (237 men and 48 women) with chronic SCI with mean
(standard deviation) injury duration 17.8 (13.2) years from the VA Boston and the
community participating in an epidemiologic study assessing factors associated
with respiratory health. METHODS: Participants (24.6% cervical American Spinal
Injury Association Impairment Scale (AIS) level A, B, and C; 33.6% other AIS A,
B, and C; 41.8% AIS D) provided a blood sample, completed a respiratory health
questionnaire, and underwent spirometry. Linear regression methods were used to
assess cross-sectional associations between plasma leptin and adiponectin with
spirometric measures of pulmonary function adjusted for age, race, gender, and
height. Level and severity of SCI, mobility mode, body mass index, smoking,
chronic obstructive pulmonary disease, asthma, chest injury history, laboratory
batch, and other potential confounders were also considered. MAIN OUTCOME
MEASUREMENTS: forced expiratory volume in 1 second (FEV1), forced vital capacity
(FVC), and FEV1/FVC. RESULTS: There was a statistically significant inverse
relationship between plasma leptin assessed in quartiles or as a continuous
covariate with FEV1 and FVC. In fully adjusted models, each interquartile range
(16,214 pg/mL) increase in leptin was associated with a significant decrease in
FEV1 (-93.1 mL; 95% confidence interval = -166.2, -20.0) and decrease in FVC
(-130.7 mL; 95% confidence interval = -219.4, -42.0). There were no significant
associations between leptin and FEV1/FVC or between plasma adiponectin with FEV1,
FVC, or FEV1/FVC. CONCLUSION: Plasma leptin in individuals with chronic SCI is
inversely associated with FEV1 and FVC, independently of SCI level and severity
and other covariates. This finding suggests that plasma leptin may contribute to
reduced pulmonary function in chronic SCI. LEVEL OF EVIDENCE: II.
CI - Copyright (c) 2018 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS