Purpose: There is an ongoing demand for easily accessible biomarkers that reflect the physiological and pathophysiological mechanisms of COPD. To test if an exercise challenge could help to identify clinically relevant metabolic biomarkers in COPD. Patients and Methods: We performed two constant-load exercise challenges separated by 4 weeks including smokers with COPD (n=23/19) and sex- and age-matched healthy smokers (n=23/20). Two hours after a standardized meal venous blood samples were obtained before, 5 mins after the start, at the end of submaximal exercise, and following a recovery of 20 mins. Data analysis was performed using mixed- effects model, with the metabolite level as a function of disease, time point and interaction terms and using each individual's resting level as reference. Results: Exercise duration was longer in healthy smokers but lactate levels were comparable between groups at all four time points. Glucose levels were increased in COPD. Glutamine was lower, while glutamate and arginine were higher in COPD. Branched-chain amino acids showed a stronger decline during exercise in healthy smokers. Carnitine and the acyl-carnitines C16 and C18:1 were increased in COPD. These metabolite levels and changes were reproducible in the second challenge. Conclusion: Higher serum glucose, evidence for impaired utilization of amino acids during exercise and a shift of energy metabolism to enhanced consumption of lipids could be early signs for a developing metabolic syndrome in COPD. In COPD patients, deviations of energy and nitrogen metabolism are amplified by an exercise challenge.
- Holz, O.
- DeLuca, D. S.
- Roepcke, S.
- Illig, T.
- Weinberger, K. M.
- Schudt, C.
- Hohlfeld, J. M.
Keywords
- *airway inflammation
- *biomarker
- *targeted metabolomics
- of the study Nycomed during its conduct
- TI: no competing interest
- KW: reports
- grants from Biocrates Life Sciences, during the conduct of the study, contract
- research revenues from Altana during the conduct of the study, is a shareholder
- of Biocrates Life Sciences and a patent WO2007003343 issued, a patent
- WO2008145385 issued, and a patent WO2010139341 issued
- CS: employee of the
- sponsor of the study Nycomed during its conduct
- JH: received grants from Nycomed
- during the conduct of the study, personal fees from Boehringer Ingelheim, grants
- from AstraZeneca AB, grants from Novartis, grants from Janssen Pharmaceutica NV,
- grants from ALK, grants from Boehringer Ingelheim, grants from LETI, grants from
- GlaxoSmithKline, GSK, grants from Sanofi-Aventis, personal fees from Merck & Co,
- Inc., personal fees from Novartis, grants from Astellas Pharma, grants from
- Allergopharma, outside the submitted work.