Table 2 Potential mediators involved in the higher prevalence of T2D in COPD
COPD | DM | Ref | |
|---|---|---|---|
CRP | COPD is independently associated with increased levels of CRP. Moreover, CRP may predict the future onset of COPD. | Elevated CRP levels may predict the development of onset of T2D. | [24] |
TNF-α | COPD is independently associated with increased levels of TNF-α. activates NF-kB leading to cytokine production, upregulation of adhesion molecules and increasing oxidative stress | May be a risk factor for the development of new onset T2D. May interfere with glucose metabolism and insulin sensitivity, and can be antagonized by adiponectin which reduces NfkB activation. | [24] |
IL-1 | IL-1 is implicated in the pathogenesis of COPD related inflammation. | An increase in IL-1β may predict the development of new onset T2D. | [24] |
IL-6 | COPD is independently associated with increased levels of IL-6. This cytokine is a potent stimulator of CRP production by the liver and may account for the increase in circulating CRP found in patients with COPD. | IL-6 was shown to increase the risk for the new onset T2D. | [24] |
Leptin | Leptin levels are increased in patients with COPD. May contribute to COPD related weight loss, PFT decline and prolonged hospital stay. Leptin induced IR and hyperglycemia | Leptin may increase the risk of T2D. Leptin may participate in the development of DM related complications via its proinflammatory actions. | |
Adiponectin | Adiponectin levels are increased in patients with COPD and low BMI, Increased adiponectin was related to a decrease in cardiovascular mortality, but was associated with an increase in mortality due to respiratory causes. | Adiponectin may prevent the development of T2D via its anti-inflammatory and proinsulin actions. | |
Resistin | Resistin levels may be increased in COPD and mediate IR. | Resistin may directly participate in the development of IR | [24] |
Catecholamine | patients with COPD had higher catecholamine levels which were independently related to a decrease in FEV1. | Insulin antagonists and contribute to the occurrence of hyperglycemia. Abnormalities in the renin angiotensin aldosterone system (RAAS) are implicated in the development and pathogenesis of cardiovascular diseases, Metabolic Syndrome and T2D | |
NF-kB | NF-kB activation is implicated in systemic inflammation and could be involved in skeletal muscle dysfunction in COPD patients | NF-kB activation has also been associated with Diabetes |