Effect of rehabilitation program on GH/IGF-1/IGF-BP3 axis and Testosterone/Cortisol ratio in patients with COPD and in healthy subjects

Mkacher W, Tabka Z, Aouichaoui C, Chaieb F, Gueddes M, Zaouali M, Zbidi A, Trabelsi Y

Abstract
Background: Skeletal muscle wasting commonly occurs in patients with chronic obstructive pulmonary disease (COPD) and has been associated with the presence of systemic inflammation and endocrinological disturbance. The aim of this study is to analyze the effect of rehabilitation program on the balance of anabolic versus catabolic hormone in patients with COPD and in healthy subjects.
Methods: Seventeen patients with COPD and sixteen age-matched healthy subjects’ underwent exercise training 3 days/week for 8 weeks. Before and after the training program the concentration of growth hormone (GH), Insulin like Growth Factor-1 (IGF-1), Insulin-like Growth Factor-Binding Protein 3 (IGF-BP3), testosterone and cortisol in serum were determined. The exercise measurements included a Six-Minute Walking Test (6MWT).
Results: After 8 weeks, there was no significant change in lung function in patients with COPD and healthy subjects. There is a significant improvement in the Six-Minute Walking distance (6MWD) in both groups (p <0.01). Dyspnea and heart rate at rest and at the peak of Six-Minute Walking Test (6MWT) decreased significantly after training program (p <0.01). Growth hormone, Insulin like Growth Factor-1 and Insulin-like Growth Factor-Binding Protein 3 increased significantly after rehabilitation training (p <0.01). The rehabilitation program improves the testosterone / cortisol ratio (T/C ratio) in both groups.
Conclusion: Pulmonary rehabilitation induces an improvement of the anabolic process and reduces protein destruction by the modifications in endocrinological factors regulating skeletal muscle in patients with COPD.

Key words: Chronic obstructive pulmonary disease, GH/IGF-1/IGF-BP3 axis, Testosterone/Cortisol ratio, pulmonary rehabilitation.