Serum Adiponectin in Hospitalised Patients with Cord: Relationship with Peripheral Muscle Function, Physical Performance and Readmissions

Background: Adiponectin (APN) is the most abundant systemic adipokine and exerts potent metabolic effects upon skeletal muscle. Skeletal muscle dysfunction is particularly marked in patients hospitalised with acute exacerbation of COPD (AECOPD). Aims: To determine if APN is associated with muscle strength, muscle mass, physical performance and disease severity in hospitalised patients with AECOPD and if APN at hospital discharge is associated with risk of readmission. Methods: 100 patients hospitalised with AECOPD were recruited. Measurements made at hospital discharge included APN, handgrip strength (HG), quadriceps maximum voluntary contraction (QMVC), fat free mass (FFM), 4-metre gait speed (4MGS), Short Physical Performance Battery (SPPB) and ADO score. Readmission rates at 90 days were recorded. Results: Median length of stay was 2.5days. Patient characteristics:mean(SD) age 70(11); 58%male;BMI 26.7(7.1);FEV1%pred 39(19);MRC dyspnoea score 4.0(1.2);HG 25.4kg (11.0);FFM 42.8kg (7.5);4MGS 0.64m/s (0.29);SPPB 6.8(3.0) and ADO 6.2(1.8); median(IQR) QMVC 15.7kg (10.9–21.9) and APN 13500ng/ml (7710-23675). APN was associated with HG (r=-0.30;p=0.002),QMVC (r=-0.40;p<0.001),FFM (r=-0.31;p=0.002),SPPB (r=-0.26;p=0.008) and ADO(r=0.20;p<0.05). There was no association with FEV1%pred. When stratified by quartiles of APN, there were increasing rates of readmission at 90 days with higher levels of APN (Q1 8%;Q2 20%;Q3 28%;Q4 40%;Χ2 for trend p=0.007). Conclusions: Higher levels of APN in hospitalised patients with AECOPD at discharge are associated with muscle weakness, loss of muscle mass, poor physical performance and increased risk of readmission.