Surfactant Protein D, a Marker of Lung Innate Immunity, Is Positively Associated With Insulin Sensitivity

J. M. Fernandez-Real, S. Valdes, M. Manco, B. Chico, P. Botas, A. Campo, R. Casamitjana, E. Delgado, J. Salvador, G. Fruhbeck, G. Mingrone, W. Ricart
<span title="2010-01-19">2010</span> <i title="American Diabetes Association"> <a target="_blank" rel="noopener" href="" style="color: black;">Diabetes Care</a> </i> &nbsp;
OBJECTIVE -Impaired lung function and innate immunity have both attracted growing interest as a potentially novel risk factor for glucose intolerance, insulin resistance, and type 2 diabetes. We aimed to evaluate whether surfactant protein D (SP-D), a lung-derived innate immune protein, was behind these associations. RESEARCH DESIGN AND METHODS -Serum SP-D was evaluated in four different cohorts. The cross-sectional associations between SP-D and metabolic and inflammatory parameters were
more &raquo; ... ed in two cohorts, the cross-sectional relationship with lung function in one cohort, and the longitudinal effects of weight loss on fasting and circadian rhythm of serum SP-D and cortisol concentrations in one prospective cohort. RESULTS -In the cross-sectional studies, serum SP-D concentration was significantly decreased in subjects with obesity and type 2 diabetes (P ϭ 0.005) and was negatively associated with fasting and postload serum glucose. SP-D was also associated with A1C, serum lipids, insulin sensitivity, inflammatory parameters, and plasma insulinase activity. Smoking subjects with normal glucose tolerance, but not smoking patients with type 2 diabetes, showed significantly higher serum SP-D concentration than nonsmokers. Serum SP-D concentration correlated positively with end-tidal carbon dioxide tension (r ϭ 0.54, P ϭ 0.034). In the longitudinal study, fasting serum SP-D concentration decreased significantly after weight loss (P ϭ 0.02). Moreover, the main components of cortisol and SP-D rhythms became synchronous after weight loss. CONCLUSIONS -These findings suggest that lung innate immunity, as inferred from circulating SP-D concentrations, is at the cross-roads of inflammation, obesity, and insulin resistance.
<span class="external-identifiers"> <a target="_blank" rel="external noopener noreferrer" href="">doi:10.2337/dc09-0542</a> <a target="_blank" rel="external noopener" href="">pmid:20086254</a> <a target="_blank" rel="external noopener" href="">pmcid:PMC2845040</a> <a target="_blank" rel="external noopener" href="">fatcat:jnjcqh3ac5dztk6g3uqxkvy4q4</a> </span>
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