Table 1_A latent metabolic dysfunction phenotype integrating insulin resistance and leptin is associated with disease severity in COPD.docx

The combined effects of insulin resistance and leptin dysregulation on COPD outcomes remain incompletely defined. This study evaluated their associations with exacerbation burden, airflow limitation and patient-reported outcomes, and assessed the discriminative performance of HOMA-IR and serum leptin for identifying advanced disease.</p>Methods<p>A cross-sectional observational study was conducted at a tertiary care centre in southern Romania, including 96 patients with COPD and 24 healthy controls.

Fasting insulin and serum leptin were measured, and insulin resistance was assessed using HOMA-IR. Spirometry and patient-reported outcomes (CAT, mMRC and SGRQ-C) were assessed in COPD patients. Metabolic markers were analysed individually and as a latent metabolic dysfunction phenotype using generalized structural equation modelling (GSEM).</p>Results<p>Compared with controls, COPD patients had higher HOMA-IR (+206.9%), insulin (+112.2%) and leptin (+52.8%) levels.