Increased resting energy expenditure is related to plasma TNF-alpha concentration in stable COPD patients.

UNLABELLED: The objective of this study was to test whether increased resting energy expenditure (REE) in chronic obstructive pulmonary disease (COPD) patients is related to increased cost of breathing and/or to increased cytokine production. In 36 non-inflammatory (CRP: 17.6 +/- 13.1 mg.l(-1), mean +/- SD; orosomucoid: 0.71 +/- 0.18 g.l(-1)), non-malnourished (BMI: 23.6 +/- 4.3 kg.m(-2)), clinically stable, non severely hypoxic COPD patients (60.5 +/- 8.9 years) we measured REE, pulmonary function and plasma cytokine concentrations (TNF-alpha, IL1 and IL6). REE was increased by 10 +/- 11% (P< 0.001) above predicted values. Plasma TNF-alpha concentration was increased in all patients (mean value 26.3 +/- 14.3 pg.ml(-1)). Excess REE (with respect to values predicted by Harris-Benedict equations) was correlated with plasma TNF-alpha concentration (P< 0.005), but not with the degree of airway obstruction, lung overinflation, or with oxygen cost of breathing. Theophylline treatment resulted in a significant increase in REE by 15%. IN
CONCLUSION: non-malnourished, clinically stable, non-severely hypoxic COPD patients display an increased REE that is related with plasma TNF-alpha concentration (without apparent systemic inflammation) and to theophylline treatment, but that is independent of parameters of respiratory function.