Kronik Obstrüktif Akciğer Hastalığının Şiddetinin Hipofizer Gonadal Aks Üzerine Etkisi

Year 2024, Volume: 50 Issue: 2, 197 - 201, 08.10.2024

İmren Mutlu Hayat , Halil Ferat Öncel

https://doi.org/10.32708/uutfd.1478705

Abstract

Bu çalışmanın amacı, kronik obstrüktif akciğer hastalığının (KOAH) spesifik klinik semptomlarında rol oynayan anabolik hormon düzeylerinin hastalığın şiddeti ile olan ilişkiyi araştırmaktır. En az iki yıldır KOAH'lı altmış dört erkek hasta çalışmaya dahil edildi. KOAH, akciğer fonksiyon testlerine dayanarak teşhis edildi ve şiddeti CAT skoru ve mMRC nefes darlığı ölçeği nefes darlığı ölçeği kullanılarak sınıflandırıldı. TSH T3 T4, FSH, LH, testosteron, prolaktin, progesteron ve CRP dahil olmak üzere çeşitli hormonların seviyeleri ölçüldü. Ayrıca arteriyel kan gazları analiz edildi. Hastalar GOLD evrelerine göre kategorize edildi. LH, FSH seviyeleri alevlenme sırasında azaldı ve LH ile düşük arteriyel oksijen seviyeleri arasında anlamlı pozitif bir korelasyon vardı. FEV1 <%50 olan şiddetli KOAH hastalarında daha düşük testosteron seviyeleri istatistiksel olarak anlamlıydı. LH, testosteron FSH, TSH, progesteron ve prolaktinde bir azalma gözlendi ve düşük kan oksijen seviyeleri gözlendi ve bu hipotalamus-hipofiz-gonadal eksende disfonksiyona işaret ediyordu. Ancak istatistiksel anlamlılık bulunmadı. Sonuç olarak, erkek KOAH hastalarında hormonal değişiklikler meydana gelir, özellikle hastalığın şiddetiyle ilişkilidir. Testesteron seviyesi KOAH şiddeti arasında istatistiksel olarak anlamlı ilişki tespit edildi. Hipokseminin daha belirgin olduğu dönemde LH azalması dikkat çekiciydi. KOAH hastalarında testesteron takviyesinin güvenliğini ve etkinliğini değerlendirmek için daha fazla araştırma gereklidir.

Keywords

Kronik Obstrüktif Akciğer Hastalığı, Hormonlar, Akciğer Fonksiyon Testi

Ethical Statement

Çalışmaya bilimsel sorumluluk yüklenerek yapmaya çalıştık. Çalışmayla ilgili herhangi bir mali çatışma ya da diğer çıkar çatışması bulunmamaktadır. Çalışmaya yapılan tüm maddi katkılar tarafımızdan karşılanılmıştır.. Makalenin bilimsel, etik ve hukuki sorumluluğu yazarlar olarak biz|ere aittir. Zaman ayırdığınız için teşekkür ederim.

Supporting Institution

YOK

Thanks

Çalışmaya gönüllü katılan hastalarımıza ve hasta yakınlarına teşekkür ederiz.

The Effect of the Severity of Chronic Obstructive Pulmonary Disease on the Pituitary Gonadal Axis

Abstract

This study aims to investigate the levels of anabolic hormone implicated in specific clinical symptoms of chronic obstructive pulmonary disease (COPD) in relation to disease severity. Sixty-four male patients with COPD for at least two years were included. COPD diagnosed was based on pulmonary function tests, with severity classified using the CAT score and mMRC breathlessness scale. Levels of various hormones including TSH T3 T4, FSH, LH, testesterone, prolactin, progesterone and CRP were measured. Arterial blood gases were also analyzed. Patients were categorized according to GOLD stages. LH, FSH levels decreased during exacerbation, with a significant positive correlation between LH and low arterial oxygen levels. lower testosterone levels were statistically significant in severe COPD patients with FEV1 < 50%. A decrease in LH, testosterone FSH, TSH, progesterone and prolactin was observed with low blood oxygen levels, indicating dysfunction in the hypothalamic-pituitary-gonadal axis. However,stastistical significance varied.In conclusion, hormonal changes occur in male COPD patients, particulary related to disease severity. Testesterone levels correlate significantly with COPD severity. LH decrease during pronounced hypoxemia period was notable. Further research is necessary to evaluate the safety and efficacy of testosterone supplementation in COPD patients.

Keywords

choronic obstructive pumnonary disease, hormones, pulmonary function test

Ethical Statement

HRÜ/22.21.12

Supporting Institution

yok

Thanks

Çalışmaya gönüllü olarak onay veren hastalarımıza teşekkür ederiz.

References

• 1.Venkatesan, P. (2024). GOLD COPD report: 2024 update. The Lancet Respiratory Medicine, 12(1), 15-16 /doi.org/10.1016/S2213-2600(23)00461-7
• 2.Mathers CD, Loncar D, Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 2006; 3: 442 https://doi.org/10.1371 journel pmed 0030442
• 3.Ansari, S., Hosseinzadeh, H., Dennis, S et al Activating primary care COPD patients with multi-morbidity through tailored self-management support. npj Primary Care Respiratory Medicine, 2020: 30(1),https://dx.doi.org/10.1038/s41533-020-0171-5
• 4.Shoukry, A., Said, N. S., Abd-Elrahman, et al, S. Thyroiddysfunction and inflammatory biomarkers in chronic obstructive pulmonary disease: Relation to severity and exacerbation. Egyptian Journal of Chest Diseases and Tuberculosis, 2013 62(4), 567-574. https://doi.org/10.1016/j.ejcdt.2013.08.011
• 5.F.,Karadag, F., Ozcan, H., Karul, et al, O. Sex hormonealterations and systemic inflammation in chronic obstructive pulmonary disease. International journal of clinical practice, 2009: 63.2: 275-281.https://doi.org/10.1111/j.1742-1241.2007.01501.
• 6.Laghı,F. Adıgüzel,N. Tobin,MJ Endocrinological derangements in COPD.EurRespirJ,2009,34: 975-96 PMID: 1979:7671 . https://doi.org/10.1183/09031936.00103708
• 7.Creutzberg EC, Casaburi R. Endocrinological disturbances inchronic obstructive pulmonary disease. Eur Respir J 2003; 22 (Ek 46): 76-80. https://doi.org/: 10.1183/09031936.03.00004610. PMID:14621109
• 8.Wouters EFM, Creutzberg EC, Schols AMWJ. Systemic effects in COPD. Chest 2002; 121: 127- 30. _doi: 10.1378/chest.121.5_suppl.127s.PMID: 12010840
• 9.Eid AA, Jonescu AA, Nixon L. S., et all Inflammatory response and body composition in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2001:164: 1414-8 doi: 10.1164/ajrccm.164.8.2008109.PMID: 11704588
• 10.Gumus A, Ozcelik N, Yilmaz Kara B, et al Thyroid Gland Disease as a Comorbid Condition in COPD Pulm Med. Oct 29;2021:7479992. doi: 10.1155/2021/7479992. eCollection 2021: https://doi.org/10.1155/2021/7479992 PMID: 34745661 PMCID: PMC 8570902
• 11.Dimopoulou I., Ilias I., Mastorakos G., et al. Effects of severityof chronic obstructive pulmonary disease on thyroid function. Metabolism 2001:50:1397-401. https://doi.org/10,1053/meta.28157
• 12.Huang D., Wu D., He J., et al B. Association between thyroid function and acute exacerbation of chronic obstructive pulmonary disease. International Journal of Chronic Obstructive Pulmonary Disease,2021:333339.PMID:33628017PMCID:PMC7898213https://doi.org/10.2147/COPD.S291807
• 13.Banks WA., Cooper JA. Hypoxia and hypercarbia of chronic lung disease: minimal effects on anterior pituitary function, South Med J ,83 1990:290-293 https://doi.org/10.1097/00007611-199003000-00009 PMID: 2107579
• 14.Karadag, F., Ozcan, H., Karul, A. et al., &Cildag, O. Correlatesof non-thyroidal illness syndrome in chronic obstructive pulmonary disease. Respiratory medicine, 2007: 101(7), 1439-1446. https://doi.org/10.1016/j.rmed.2007.01.016
• 15.Casaburi R., Bhasin S., Cosentino L., et al, Effects oftestosterone and resistance training in men with chronic obstructive pulmonary disease American journal of respiratory and critical care medicine, 170(8),870-878. Am J Respir CritCare Med 2004: 170: 870 – 878 https://doi.org/10.1164/rccm.200305-617OC PubMed:15271690
• 16.Akbaş, T. Yoğun bakım hastalarında Hipofizer-Gonadal Aks Ve Klinik Seyir. 2007: PhD Thesis. Marmara Universitesi(Turkey).
• 17.Akbaş, T., Karakurt, S., Ünlügüzel, G., et al The endocrinologic changes in critically ill chronic obstructive pulmonary disease patients. COPD: Journal of Chronic Obstructive Pulmonary Disease, 7(4), 240-247.https://doi.org/10.3109/15412555.2010.496815
• 18.Makarevich AE., Makarevich AE., (2003). Disorders of sexhormone status in patients with chronic obstructive pulmonary disease. WiadomosciLekarskie Warsaw, Poland: 1960: 56(3-4), 140-146. PMID:12923960
• 19.Kawshty, H., Makki, M. A., Elmorsy, et al Is chronic obstructive pulmonary disease a risk factor for erectile dysfunction? Across-sectional, comparative study. Al-Azhar Assiut Medical Journal, 2019: 17(1), 79-85 https://doi.org/10.4103/AZMJ.AZMJ_26_19
• 20.Mousavi, S. A. J., Kouchari, M. R., Samdani-Fard, et al Relationship between serum levels of testosterone and the severity of chronic obstructive pulmonary disease. Tanaffos, 2012: 11(3), 32. PMCID: PMC4153207 PMID: 25191426
• 21.Castro, H. M., Furcada, J. M., Knoblovits, P., et al. Testosterone levels and their association with COPD severity:A cross sectional study Eur Respiratory Soc 2018; 2:PA3624 https://doi.org/:10.1183/13993003.congress- 2018PA3624
• 22.Daabis, RG, Rehem, RNA, Hassan, MM et al. Hypogonadism in patients with chronic obstructive pulmonary disease:relationship with airflow limitation, muscle weakness and systemic inflammation. AlexandriaJournalofMedicine, 2016 :52(1),27-33. https://doi.org/10.1016/j.ajme.2015.01.002
• 23.SemplePd'A, Beastall GH, Watson WS, et al Serum testosteronedepression associated with hypoxia in respiratory failure.Clinical science (London, England), 1980: 58(1), 105-106. https://doi.org/10.1042/cs0580105
• 24.John M, Lange A, Hoernig S, et al. Prevalence of anemia in chronic obstructive pulmonary disease: comparison to other chronic diseases. Int J Cardiol2006: 111: 365-370. https://doi.org/10.1016/j.ijcard.2005.07.043
• 25.Gan, W. Q., Man, S. F. P., Senthilselvan, A., et al.Associationbetween chronic obstructive pulmonary disease and systemicinflammation: asystematic review and ameta-analysis.Thorax.2004: 59: 574-580.http://dx.doi.org/10.1136/thx.2003.019588
• 26.Piehl-Aulin, K., Jones, I., Lindvall, B., et al. Increased serum inflammatory markers in the absence of clinical and skeletal muscle inflammation in patients with chronic obstructive pulmonary disease. Respiration, (78)2009: 191-196. PMID: 19270439 https://doi.org/10.1159/000207793
• 27.De Torres, J. P., Cordoba-Lanus, E., & Lopez-Aguilar, C. C-reactive protein levels and clinically important predictive outcomes in stable COPD patients. Eur. Resp.J. 827)2006: S 902-907 https://doi.org/: 10.1183/09031936.06.00109605.
• 28.Shaker, A., El-Shora, A., El-Gammal, et al. Endocrinal disturbances and systemic inflammatiom in chronic obstructive pulmonary disease (COPD). Egyptian Journal of Chest Diseases and Tuberculosis, 2012: 61.3: 81-88https://doi.org/10.1016/j.ejcdt.2012.10.011