Preliminary study of the anabolic/catabolic balance in patients with interstitial pulmonary fibrosis

Rationale: Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic, progressively fibrosing idiopathic interstitial pneumonias (IIP), as the disease progress, patients become severely limited in their activity. Hypoxemia is a common finding in IPF and may influence skeletal muscles homeostasis in several ways by decreasing anabolic hormone level [insulin like growth factor-1 (ILGF-1)] with as opposite effect on pro inflammatory cytokines as interleukin-6 (IL-6). It has been speculated that peripheral muscle force is inversely related to IL-6 and disturbed systemic levels of ILGF-1 may be important in the development of muscle weakness.Objectives: To assess the metabolic disturbance and its reflection on the muscular state in IPF patients.Methods: The muscular state was assisted in 22 newly diagnosed IPF patients (not on steroids) (group 1) and 22 previously diagnosed IPF patients (on steroids) (group 2) by anthropometric measurements [Mid-thigh cross sectional area (MTCSA) and Mid- arm cross sectional area (MAC)], Body Mass Index (BMI) and measurements of serum levels of ILGF-1 and IL-6 by ELISA. Twenty two healthy subjects were selected as control (group 3).Results: There were no significant difference between the three groups as regards BMI, MTCSA and MAC. However, there was a highly significant decrease in the mean of serum IGF-1 level of group 1 in comparison to the control group (P < 0.001). As regards, the mean of the serum IL-6 level there was no significant difference between the three groups.Conclusions: The metabolic disturbance as regards the anabolic hormone level IGF-1 was the most affected in comparison to the other parameters