Endocrinological changes in chronic obstructive pulmonary disease

8. SUMMARYENDOCRINOLOGICAL CHANGES IN CHRONIC OBSTRUCTIVEPULMONARY DISEASECOPD is characterized by significant chronic inflammation not only in the pulmonarycompartment, but also in systemic circulation and this disorder is associated with clinicallysignificant systemic alterations in biochemistry and organ function. Systemic aspects ofCOPD include oxidative stress and altered circulating levels of inflammatory mediators.Several factors such as hypoxemia, exacerbation, drugs, malnutrition lead to endocrinologicalchanges in COPD. The aim of this study was to evaluate the alterations in thyroid and sexhormon levels and the determinants of these alterations in COPD.103 COPD patients and 30 control subjects were admitted to the study. 83 stableCOPD patients and 30 control subjects were evaluated as outpatients. 20 patients with COPDexacerbation were hospitalised and evaluated before discaharge and after one month.TT3, fT3, TT3/TT4 levels of both stable and exacerbation COPD groups were lowerthan the control subjects. Besides TSH was also lower than controls during exacerbation.Testosteron and DHEA-SO4 levels of both COPD groups were lower than the control group.FSH and LH levels were increased during exacerbation.TSH, TT3, fT3, testosteron, DHEA-SO4, estrodiol, prolactin levels and TT3/TT4 ratioincresed in controls before discharge and after one month in COPD exacerbation group;whereas LH level was higher during hospitalization and decreased in follow-up.TT3, testosteron, DHEA-SO4 levels and TT3/TT4 ratio was lower in severe COPD(FEV1<50%) and in patients with severe hypoxemia (PaO2<60mmHg). TSH and fT3 levelswere also lower in severely hypoxemic patients. Testosteron and DHEA-SO4 levels werelower in hypercapnic patients (PaCO2>45mmHg).In conclusion, there are alterations in thyroid and sex hormon levels in COPD which isa systemic disease. The hormonal alterations are especially related to severity of the diseaseand hypoxemia. There are differences in hormon levels during stable and exacerbation phasesof COPD; the hormonal changes are marked during exacerbation and partially regresses afterone month when the disease is stabilised.