Surfactant protein D, a marker of lung innate immunity, is positively associated with insulin sensitivity

José Manuel Fernández-Real, Sergio Valdés, Melania Manco, Berta Chico, Patricia Botas, Arantza Campo, Roser Casamitjana, Elías Delgado, Javier Salvador, Gema Fruhbeck, Geltrude Mingrone, Wifredo Ricart

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Abstract

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 evaluated 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 = 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 = 0.54, P = 0.034). In the longitudinal study, fasting serum SP-D concentration decreased significantly after weight loss (P = 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.

Original languageEnglish
Pages (from-to)847-853
Number of pages7
JournalDiabetes Care
Volume33
Issue number4
DOIs
Publication statusPublished - Apr 2010

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Pulmonary Surfactant-Associated Protein D
Innate Immunity
Insulin Resistance
Lung
Blood Proteins
Type 2 Diabetes Mellitus
Weight Loss
Fasting
Hydrocortisone
Obesity
Insulysin
Smoking
Glucose
Cohort Effect
Glucose Intolerance
Circadian Rhythm
Serum
Carbon Dioxide
Longitudinal Studies
Research Design

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialised Nursing

Cite this

Fernández-Real, J. M., Valdés, S., Manco, M., Chico, B., Botas, P., Campo, A., ... Ricart, W. (2010). Surfactant protein D, a marker of lung innate immunity, is positively associated with insulin sensitivity. Diabetes Care, 33(4), 847-853. https://doi.org/10.2337/dc09-0542

Surfactant protein D, a marker of lung innate immunity, is positively associated with insulin sensitivity. / Fernández-Real, José Manuel; Valdés, Sergio; Manco, Melania; Chico, Berta; Botas, Patricia; Campo, Arantza; Casamitjana, Roser; Delgado, Elías; Salvador, Javier; Fruhbeck, Gema; Mingrone, Geltrude; Ricart, Wifredo.

In: Diabetes Care, Vol. 33, No. 4, 04.2010, p. 847-853.

Research output: Contribution to journalArticle

Fernández-Real, JM, Valdés, S, Manco, M, Chico, B, Botas, P, Campo, A, Casamitjana, R, Delgado, E, Salvador, J, Fruhbeck, G, Mingrone, G & Ricart, W 2010, 'Surfactant protein D, a marker of lung innate immunity, is positively associated with insulin sensitivity', Diabetes Care, vol. 33, no. 4, pp. 847-853. https://doi.org/10.2337/dc09-0542
Fernández-Real, José Manuel ; Valdés, Sergio ; Manco, Melania ; Chico, Berta ; Botas, Patricia ; Campo, Arantza ; Casamitjana, Roser ; Delgado, Elías ; Salvador, Javier ; Fruhbeck, Gema ; Mingrone, Geltrude ; Ricart, Wifredo. / Surfactant protein D, a marker of lung innate immunity, is positively associated with insulin sensitivity. In: Diabetes Care. 2010 ; Vol. 33, No. 4. pp. 847-853.
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AU - Chico, Berta

AU - Botas, Patricia

AU - Campo, Arantza

AU - Casamitjana, Roser

AU - Delgado, Elías

AU - Salvador, Javier

AU - Fruhbeck, Gema

AU - Mingrone, Geltrude

AU - Ricart, Wifredo

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