• Shireen Jawed Department, Physiology, University Medical and Dental College Faisalabad, University of Faisalabad
  • Nighat Mannan Bahria University Medical and Dental College, Karachi
  • Masood Anwar Qureshi Institute of Basic Medical Sciences, Dow University of Health Sciences, Karachi


Background: Obesity is associated with inflammatory diseases and obese individual’s poses high risk for infections. Surfactant protein D (SP-D) is an important regulator of immunity and inflammation. Latest studies have suggested that it is also involved in lipid homeostasis and obese subjects have decrease concentration of SP-D as compared to normal weight peoples. The aim of the current study was to elucidate the relationship among serum SP-D and BMI. Method: This cross sectional study was performed at Dow University of health sciences (DUHS), Karachi. We analysed 90 obese and non-obese subjects for serum SP-D concentration. SP-D was estimated by ELISA. Data was analysed by SPSS 16. Mean SP-D level and demographical variables between the groups were compared by t test, Associations of SP-D with BMI investigated by regression analysis. Results: obese subjects have significant lower levels of Serum SP-D than non-obese and negatively associated with BMI in both genders (p=0.000). Conclusion: This study concluded that obese subjects have lower concentration of SP-D as compare to non-obese and there is an inverse association between the SP-D and BMI.Keywords: Surfactant Protein- D, Obesity, Total Body Mass Index (BMI), inflammatory diseases


Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: asystematic analysis for the Global Burden of Disease Study 2013. Lancet 2014;384(9945):766–81.

Sherin A. Obesity: how to prevent Pakistani people from getting heavier? Khyber Med Univ J 2014;5(2):59–60.

Nur T, Shah U, Zehra N. Majority of the population disregards obesity a Health Risk: Obesity among different Socioeconomic Strata in Karachi - A Hospital Case study. Pak J Med Dent 2013;2(3):43–8.

Low S, Chin MC, MA S, Heng D, Deurenberg-Yap M. Rationale for redefining obesity in Asian. J Ann Acad Med Singapore 2009;38(1):66–74.

Sarvottam K, Yadav RK. Obesity-related inflammation & cardiovascular disease: efficacy of a yoga-based lifestyle intervention. Indian J Med Res 2014;139(6):822–34.

Karlsson EA, Beck MA. The burden of obesity on infectious disease. J Exp Biol Med (Maywood) 2010;235(12):1412–24.

Ortega FJ, Pueyo N, Moreno-Navarrete JM, Sabater M, Rodriguez-Hermosa JI, Ricart W, et al. The lung innate immune gene surfactant protein-D is expressed in adipose tissue and linked to obesity status. Int J Obes (Lond) 2013;37(12):1532–8.

Pan WH, Flegal KM, Chang HY, Yeh WT, Yeh CJ, Lee WC. Body mass index and obesity-related metabolic disorders in Taiwanese and US whites and blacks: implications for definitions of overweight and obesity for Asians. Am J Clin Nutr 2004;79(1):31–9.

Kishore U, Greenhough TJ, Waters P, Shrive AK, Ghai R, Kamran MF, et al. Surfactant proteins SP-A and SP-D: structure, function and receptors. Mol Immunol 2006;43(9):293–315.

Shrive AK, Tharia HA, Strong P, Kishore U, Burns I, Rizkallah PJ, et al. High-resolution structural insights into ligand binding and immune cell recognition by human lung surfactant protein D. J Mol Biol 2003;331(2):509–23.

Ishii T, Hagiwara K, Ikeda S, Arai T, Mieno MN, Kumasaka T, et al. Association between genetic variations in surfactant protein d and emphysema, interstitial pneumonia, and lung cancer in a Japanese population. COPD 2012;9(4):409–16.

Zhao XM, Wu YP, Wei R, Cai HX, Tornoe I, Han JJ, et al. Plasma surfactant protein D levels and the relation to body mass index in a chinese population. Scand J Immunol 2007;66(1):71–6.

Hawgood S, Ochs M, Jung A, Akiyama J, Allen L, Brown C, et al. Sequential targeted deficiency of SP-A and -D leads to progressive alveolar lipoproteinosis and emphysema. Am J Physiol Lung Cell Mol Physiol 2002;283(5):1002–10.

Sorensen GL, Hjelmborg JV, Leth-Larsen R, Schmidt V, Fenger M, Poulain F, et al. Surfactant protein D of the innate immune defence is inversely associated with human obesity and SP-D deficiency infers increased body weight in mice. Scand J Immunol 2006;64(6):633–8.

Karlsson EA, BeckMA. The burden of obesity on infectious diseases. J ExpBiol Med 2010;235(12):1412–24

Madsen J, Kliem A, Tornoe I, Skjodt K, Koch C, Holmskov U. Localization of lung surfactant protein D on mucosal surfaces in human tissues. J Immunol 2000;164(11):5866–70.

Heidinger K, König IR, Bohnert A, Kleinsteiber A, Hilgendorff A, Gortner L, et al. Polymorphisms in the human surfactant protein-D (SFTPD) gene: strong evidence that serum levels of surfactant protein-D (SP-D) are genetically influenced. Immunogenetics 2005;57(1-2):1–7.

Leth-Larsen R, Garred P, Jensenius H, Meschi J, Hartshorn K, Madsen J, et al. A common polymorphism in the SFTPD gene influences assembly, function, and concentration of surfactant protein D. J Immunol 2005;174(3):1532–8.

Shakoori TA, Bokhari SNH, Ghafoor F, Bashir S., Serum surfactant protein D levels are associated with body mass index in the Pakistani population. Pak J Physiol 2008;4(Suppl 1):31

Shakoori TA, Sin DD, Bokhari SN, Ghafoor F, Shakoori AR. SP-D polymorphisms and the risk of COPD. Dis Markers 2012;33(2):91–100.