目的:慢性阻塞性肺疾病(COPD)患者经常表现出无法维持姿势平衡的状态。然而,肠道通透性增加或肠道渗漏对COPD体位失衡的影响尚不清楚.
方法:我们测量了血浆zonulin,肠漏的标志,与男性对照(n=70)和轻度患者(n=67)的姿势平衡有关,中等(n=66),和重度(n=58)COPD。我们使用了一个短的物理性能电池来评估仰卧时的姿势平衡,串联,和半串联位置。我们还测量了手握强度(HGS),步态速度,血浆C反应蛋白(CRP),和8-异前列腺素作为姿势失衡和漏肠之间的潜在机械联系。
结果:COPD患者表现出更高的血浆zonulin,CRP,和8-异前列腺素水平和较低的平衡,HGS,和步态速度比对照组(所有p<0.05)。这些发现在中度和重度COPD患者中比轻度COPD患者更可靠。此外,血浆zonulin在诊断平衡不良方面表现出显著的潜力,低HGS,COPD患者的步态速度(均p<0.05)。我们还发现血浆zonulin与CRP和8-异前列腺素显著相关,提供高度的炎症和氧化应激作为肠漏和姿势失衡之间的机械联系。
结论:血浆zonulin可能有助于评估COPD患者的姿势失衡。修复肠漏可以是改善COPD姿势控制的治疗目标。
OBJECTIVE: Patients with chronic obstructive pulmonary disease (COPD) frequently exhibit an inability to maintain postural balance. However, the contribution of increased intestinal permeability or leaky gut to the postural imbalance in COPD is not known.
METHODS: We measured plasma zonulin, a marker of leaky gut, with relevance to postural balance in male controls (n = 70) and patients with mild (n = 67), moderate (n = 66), and severe (n = 58) COPD. We employed a short physical performance battery to evaluate postural balance in supine, tandem, and semi-tandem positions. We also measured handgrip strength (HGS), gait speed, plasma c-reactive proteins (CRP), and 8-isoprostanes as potential mechanistic connections between postural imbalance and leaky gut.
RESULTS: COPD patients demonstrated higher plasma zonulin, CRP, and 8-isoprostanes levels and lower balance, HGS, and gait speed than controls (all p < 0.05). These findings were more robust in patients with moderate and severe than mild COPD. In addition, plasma zonulin exhibited significant potential in diagnosing poor balance, low HGS, and gait speed in COPD patients (all p < 0.05). We also found significant correlations of plasma zonulin with CRP and 8-isoprostanes, providing heightened inflammation and oxidative stress as mechanistic connections between leaky gut and postural imbalance.
CONCLUSIONS: Plasma zonulin may be helpful in evaluating postural imbalance in COPD patients. Repairing intestinal leaks can be a therapeutic target to improve postural control in COPD.