الفهرس 
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Abstract
Background: Malnutrition occurs in approximately one-quarter to one-third of patients with moderate to severe COPD. Both fat mass and fat-free mass become depleted. Loss of fat-free mass is the more important and appears to be due to depression of protein synthesis. Experimental and clinical research supports the hypothesis of involvement of the hormone leptin in body weight and energy balance homeostasis Aim: This work was planned to detect the correlation between bmi, serum leptin and pulmonary function tests in COPD. Methods: The present study included 40 male smoker COPD patients classified into 2 subgroups 16 with predominant emphysema and 24 with predominant chronic bronchitis and 10 control healthy subjects. All subjects included in this study were subjected to history taking and clinical examination, pulmonary function testing, plain chest x-ray, high resolution CT (HRCT), calculation of body mass index (BMI) and determination of serum leptin level and routine laboratory investigations (CBC, blood sugar kidney and liver functions). Result: The mean value of serum leptin levels was (2.42 1.60 ng/ml) in COPD patients and in the healthy controls was (3.99 1.22 ng/ml). This difference was of statistical significance (p = 0.006). The mean value of BMI was significantly lower in the subgroup A patients (21.07 4.6 kg/m2) compared with the subgroup B patients (26.30 4.3 kg/m2), (p = 0.001). The mean value of serum leptin levels was significantly lower in the subgroup A patients (1.58 1.04 ng/ml) as compared to the subgroup B patients (2.97 1.68 ng/ml), (p = 0.006). The subgroup A patients had a significantly lower arterial PaO2 (65.6 10.7 mmHg) compared with the subgroup B patients (76.1 14.0 mmHg) (p = 0.016). There was a strongly significant positive correlation between BMI (kg/m2) and serum leptin levels (ng/ml) in the COPD patients (P = 0.000). There were statistically significant positive correlations between FEV1/Predicted%, FEV1/FVC% and serum leptin levels (P = 0.000 and P = 0.001 respectively), while there were statistically significant negative correlations between RV/Predicted%, RV/TLC% and serum leptin levels (p = 0.002 and p = 0.042 respectively) in COPD patients. Conclusion: ” Leptin may play a role in pathophysiology of cachexia and progression of COPD. Body mass index (BMI) can be used as a simple and easily applicable tool for follow up and assessment of the disease progression in COPD patients in outpatient clinics.