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ABSTRACT: Background
The aim of this substudy of the ghrelin treatment, multicenter, randomized, double-blind, placebo-controlled trial was to investigate the effects of ghrelin administration on exercise capacity and the underlying mechanisms in underweight patients with chronic obstructive pulmonary disease (COPD) using cardiopulmonary exercise testing.Methods
Twenty underweight COPD patients were randomized to pulmonary rehabilitation with intravenous ghrelin (2 ?g/kg, n = 10) or placebo (n = 10) twice daily for 3 weeks in a double-blind fashion. The primary outcome was changes in peak oxygen uptake V•o2. Secondary outcomes included changes in exertional cardio-respiratory functions: O2-pulse, physiologic dead space/tidal volume-ratio (VD/VT), ventilatory equivalent for oxygen V•E/V•o2, and ventilatory equivalent for carbon dioxide V•E/V•co2.Results
With incremental exercise, at peak exercise, there was a significant difference in the mean difference (ghrelin minus placebo), i.e., treatment effect in: i) peak V•o2 (1.2 mL/kg/min, 95% CI: 0.2-2.3 mL/kg/min, between-group p = 0.025); ii) V•E/V•o2 (-4.2, 95% CI: -7.9 to -0.5, between-group p = 0.030); iii) V•E/V•co2 (-4.1, 95% CI: -8.2 to -0.1, between-group p = 0.045); iv) VD/VT (-0.04, 95% CI: -0.08 to -0.00, between-group p = 0.041); and v) O2-pulse (0.7 mL/beat, 95% CI: 0.3 to 1.2 mL/beat, between-group p = 0.003). Additionally, repeated-measures analysis of variance (ANOVA) indicated a significant time-course effect of ghrelin versus placebo in the peak V•o2 (p = 0.025).Conclusion
Ghrelin administration was associated with improved exertional capacity and improvements in ventilatory-cardiac parameters.Trial registration
UMIN (University Hospital Medical Information Network in Japan) C000000061.
SUBMITTER: Miki K
PROVIDER: S-EPMC3683541 | biostudies-literature | 2013 Jun
REPOSITORIES: biostudies-literature
Miki Keisuke K Maekura Ryoji R Nagaya Noritoshi N Kitada Seigo S Miki Mari M Yoshimura Kenji K Tateishi Yoshitaka Y Motone Masaharu M Hiraga Toru T Mori Masahide M Kangawa Kenji K
BMC pulmonary medicine 20130610
<h4>Background</h4>The aim of this substudy of the ghrelin treatment, multicenter, randomized, double-blind, placebo-controlled trial was to investigate the effects of ghrelin administration on exercise capacity and the underlying mechanisms in underweight patients with chronic obstructive pulmonary disease (COPD) using cardiopulmonary exercise testing.<h4>Methods</h4>Twenty underweight COPD patients were randomized to pulmonary rehabilitation with intravenous ghrelin (2 μg/kg, n = 10) or placeb ...[more]