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Published in: Internal and Emergency Medicine 4/2014

01-06-2014 | IM - ORIGINAL

COPD patients with and without metabolic syndrome: clinical and functional differences

Authors: Jesús Díez-Manglano, José Barquero-Romero, Pedro Almagro, Francisco Javier Cabrera, Francisco López García, Lorena Montero, Joan Baptiste Soriano, Working Group on COPD; Spanish Society of Internal Medicine

Published in: Internal and Emergency Medicine | Issue 4/2014

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Abstract

Chronic obstructive pulmonary disease (COPD) and the metabolic syndrome (MetS) are considered public health challenges of the 21st century. The coexistence of MetS in COPD patients and any clinical differences between COPD patients with and without MetS have not been extensively studied. We aimed to describe the clinical characteristics of patients with MetS and COPD. An observational, multicenter study of 375 patients hospitalized for a COPD exacerbation with spirometric confirmation was performed. We measured the components of the MetS and collected comorbidity information using the Charlson index and other conditions. Dyspnea, use of steroids, exacerbations, and hospitalizations were also investigated. The overall prevalence of MetS in COPD patients was 42.9 %, was more frequent in women (59.5 %) than men (40.8 %), p = 0.02, but with no differences in age and smoking history. COPD patients with MetS had greater % predicted FEV1, more dyspnea, and more comorbidity and used more inhaled steroids (all p < 0.05). Diabetes, osteoporosis, coronary artery disease, and heart failure were more frequent in patients with MetS. They had been hospitalized more frequently for any cause but not for COPD. In multivariate analysis, the presence of MetS was independently associated with greater FEV1, inhaled steroids use, osteoporosis, diabetes, and heart failure. MetS is a frequent condition in COPD patients, and it is associated with greater FEV1, more dyspnea, and more comorbidities.
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Literature
1.
go back to reference Global Initiative for Chronic Obstructive Lung Disease (GOLD) (2011) Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (updated 2011). Available from: http://www.goldcopd.com Global Initiative for Chronic Obstructive Lung Disease (GOLD) (2011) Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (updated 2011). Available from: http://​www.​goldcopd.​com
3.
go back to reference Finkelstein J, Cha E, Scharf SM (2009) Chronic obstructive pulmonary disease as an independent risk factor for cardiovascular morbidity. Int J Chron Obstruct Pulmon Dis 4:337–349PubMedCentralPubMedCrossRef Finkelstein J, Cha E, Scharf SM (2009) Chronic obstructive pulmonary disease as an independent risk factor for cardiovascular morbidity. Int J Chron Obstruct Pulmon Dis 4:337–349PubMedCentralPubMedCrossRef
5.
go back to reference Alberti KGMM, Eckel RH, Grundy SM et al (2009) Harmonizing the metabolic syndrome. A joint interim statement of the International Diabetes Federation task force on epidemiology and prevention; National Heart, Lung and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 120:1640–1645PubMedCrossRef Alberti KGMM, Eckel RH, Grundy SM et al (2009) Harmonizing the metabolic syndrome. A joint interim statement of the International Diabetes Federation task force on epidemiology and prevention; National Heart, Lung and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 120:1640–1645PubMedCrossRef
6.
go back to reference Ervin RB (2009) Prevalence of metabolic syndrome among adult 20 years of age or over, by sex, age, race, and ethnicity, and body mass index: United States 2003–2006. Natl Health Stat Rep 13:1–7 Ervin RB (2009) Prevalence of metabolic syndrome among adult 20 years of age or over, by sex, age, race, and ethnicity, and body mass index: United States 2003–2006. Natl Health Stat Rep 13:1–7
7.
go back to reference Ford ES (2005) Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adult in the U.S. Diabetes Care 28:2745–2749PubMedCrossRef Ford ES (2005) Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adult in the U.S. Diabetes Care 28:2745–2749PubMedCrossRef
8.
go back to reference Hildrum B, Mykletun A, Hole T et al (2007) Age-specific prevalence of the metabolic syndrome defined by the International Diabetes Federation and the national Cholesterol Education Program: the Norwegian HUNT 2 study. BMC Public Health 7:220PubMedCentralPubMedCrossRef Hildrum B, Mykletun A, Hole T et al (2007) Age-specific prevalence of the metabolic syndrome defined by the International Diabetes Federation and the national Cholesterol Education Program: the Norwegian HUNT 2 study. BMC Public Health 7:220PubMedCentralPubMedCrossRef
9.
go back to reference Galassi A, Reynolds K, He J (2006) Metabolic syndrome and risk of cardiovascular disease: a meta-analysis. Am J Med 119:812–819PubMedCrossRef Galassi A, Reynolds K, He J (2006) Metabolic syndrome and risk of cardiovascular disease: a meta-analysis. Am J Med 119:812–819PubMedCrossRef
10.
go back to reference Hu G, Qiao Q, Tuomilehto J, for the DECODE Study Group et al (2004) Prevalence oh the metabolic syndrome and its relation to all-cause and cardiovascular mortality in nondiabetic European men and women. Arch Intern Med 164:1066–1076PubMedCrossRef Hu G, Qiao Q, Tuomilehto J, for the DECODE Study Group et al (2004) Prevalence oh the metabolic syndrome and its relation to all-cause and cardiovascular mortality in nondiabetic European men and women. Arch Intern Med 164:1066–1076PubMedCrossRef
11.
go back to reference Watz H, Waschki B, Kirsten A et al (2009) The metabolic syndrome in patients with chronic bronchitis and COPD. Frequency and associated consequences for systemic inflammation and physical inactivity. Chest 136:1039–1046PubMedCrossRef Watz H, Waschki B, Kirsten A et al (2009) The metabolic syndrome in patients with chronic bronchitis and COPD. Frequency and associated consequences for systemic inflammation and physical inactivity. Chest 136:1039–1046PubMedCrossRef
12.
go back to reference Minas M, Kostikas K, Papaioannou AI et al (2011) The association of metabolic syndrome with adipose tissue hormones and insulin resistance in patients with COPD without co-morbidities. COPD 8:414–420PubMedCrossRef Minas M, Kostikas K, Papaioannou AI et al (2011) The association of metabolic syndrome with adipose tissue hormones and insulin resistance in patients with COPD without co-morbidities. COPD 8:414–420PubMedCrossRef
13.
go back to reference Almagro P, López García F, Cabrera FJ, grupo EPOC de la Sociedad Española de Medicina Interna et al (2010) Comorbidity and gender-related differences in patients hospitalized for COPD. The ECCO study. Respiration 104:253–259 Almagro P, López García F, Cabrera FJ, grupo EPOC de la Sociedad Española de Medicina Interna et al (2010) Comorbidity and gender-related differences in patients hospitalized for COPD. The ECCO study. Respiration 104:253–259
14.
go back to reference Almagro P, López García F, Cabrera FJ, Grupo EPOC de la Sociedad Española de Medicina Interna et al (2010) Study of the comorbidities in hospitalized patients due to decompensated chronic obstructive pulmonary disease attended in the Internal Medicine Services. ECCO Study. Rev Clin Esp 210:101–108PubMedCrossRef Almagro P, López García F, Cabrera FJ, Grupo EPOC de la Sociedad Española de Medicina Interna et al (2010) Study of the comorbidities in hospitalized patients due to decompensated chronic obstructive pulmonary disease attended in the Internal Medicine Services. ECCO Study. Rev Clin Esp 210:101–108PubMedCrossRef
15.
go back to reference Charlson ME, Pompei P, Ales KL et al (1987) A new method of classifying prognostic comorbidity in longitudinal studies. J Chronic Dis 40:373–383PubMedCrossRef Charlson ME, Pompei P, Ales KL et al (1987) A new method of classifying prognostic comorbidity in longitudinal studies. J Chronic Dis 40:373–383PubMedCrossRef
17.
go back to reference Lam KBH, Jordan RE, Jiang CQ et al (2010) Airflow obstruction and metabolic syndrome: the Guangzhou Biobank Cohort Study. Eur Respir J 35:317–323 Lam KBH, Jordan RE, Jiang CQ et al (2010) Airflow obstruction and metabolic syndrome: the Guangzhou Biobank Cohort Study. Eur Respir J 35:317–323
18.
go back to reference Funakoshi Y, Omori H, Mihara S et al (2010) Association between airflow obstruction and the metabolic syndrome and its components in Japanese men. Intern Med 49:2093–2099PubMedCrossRef Funakoshi Y, Omori H, Mihara S et al (2010) Association between airflow obstruction and the metabolic syndrome and its components in Japanese men. Intern Med 49:2093–2099PubMedCrossRef
19.
go back to reference Poulain M, Doucet M, Fournier G et al (2008) Metabolic and inflammatory profile in obese patients with chronic obstructive pulmonary disease. Chron Respir Dis 5:35–41PubMedCrossRef Poulain M, Doucet M, Fournier G et al (2008) Metabolic and inflammatory profile in obese patients with chronic obstructive pulmonary disease. Chron Respir Dis 5:35–41PubMedCrossRef
20.
go back to reference Marquis C, Maltais F, Duguay V et al (2005) The metabolic syndrome in patients with chronic obstructive pulmonary disease. J Cardiopulm Rehabil 25:226–232PubMedCrossRef Marquis C, Maltais F, Duguay V et al (2005) The metabolic syndrome in patients with chronic obstructive pulmonary disease. J Cardiopulm Rehabil 25:226–232PubMedCrossRef
21.
go back to reference Cecere LM, Littman AJ, Slatore CG et al (2001) Obesity and COPD: associated symptoms, health-related quality of life and medication use. COPD 8:275–284CrossRef Cecere LM, Littman AJ, Slatore CG et al (2001) Obesity and COPD: associated symptoms, health-related quality of life and medication use. COPD 8:275–284CrossRef
22.
go back to reference García-Aymerich J, Gómez FP, Benet M, Farrero E, Basagaña X, Gayete A et al (2011) Identification and perspective validation of clinically relevant chronic obstructive pulmonary disease (COPD) subtypes. Thorax 66:430–437PubMedCrossRef García-Aymerich J, Gómez FP, Benet M, Farrero E, Basagaña X, Gayete A et al (2011) Identification and perspective validation of clinically relevant chronic obstructive pulmonary disease (COPD) subtypes. Thorax 66:430–437PubMedCrossRef
23.
go back to reference Küpeli E, Ulubay G, Ulasli SS et al (2010) Metabolic syndrome is associated with increased risk of acute exacerbation of COPD: a preliminary study. Endocrine 38:76–82PubMedCrossRef Küpeli E, Ulubay G, Ulasli SS et al (2010) Metabolic syndrome is associated with increased risk of acute exacerbation of COPD: a preliminary study. Endocrine 38:76–82PubMedCrossRef
24.
go back to reference Visser M, Bouter LM, McQuillan GM, Wener MH, Harris TB (1999) Elevated C-reactive protein levels in overweight and obese adults. JAMA 282:2131–2135PubMedCrossRef Visser M, Bouter LM, McQuillan GM, Wener MH, Harris TB (1999) Elevated C-reactive protein levels in overweight and obese adults. JAMA 282:2131–2135PubMedCrossRef
25.
go back to reference Yudkin JS, Stehouwer CDA, Emeis JJ, Coppack SW (1999) C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction. A potential role for cytokines originating from adipose tissue? Artherioscler Thromb Vasc Biol 19:972–978CrossRef Yudkin JS, Stehouwer CDA, Emeis JJ, Coppack SW (1999) C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction. A potential role for cytokines originating from adipose tissue? Artherioscler Thromb Vasc Biol 19:972–978CrossRef
26.
go back to reference Von Muhlen D, Safii S, Jassal SK, Svartberg J, Barrett-Connor F (2007) Associations between the metabolic syndrome and bone health in older men and women: the Rancho Bernardo Study. Osteopor Int 18:1337–1344CrossRef Von Muhlen D, Safii S, Jassal SK, Svartberg J, Barrett-Connor F (2007) Associations between the metabolic syndrome and bone health in older men and women: the Rancho Bernardo Study. Osteopor Int 18:1337–1344CrossRef
27.
go back to reference San Roman Teran C, Guijarro Merino R, Gomez Huelgas R, Montero L (2007) Epidemiologia hospitalaria de la EPOC en Espana. Rev Clin Esp 207(Suppl 1):3–7 San Roman Teran C, Guijarro Merino R, Gomez Huelgas R, Montero L (2007) Epidemiologia hospitalaria de la EPOC en Espana. Rev Clin Esp 207(Suppl 1):3–7
28.
go back to reference Pozo-Rodriguez F, Alvarez CJ, Castro-Acosta A, Melero Moreno M, Capelastegui A, Esteban C et al (2010) Clinical audit of patients admitted to hospital in Spain due to exacerbation of COPD (AUDIPOC Study): method and organization. Arch Bronconeumol 46:340–457CrossRef Pozo-Rodriguez F, Alvarez CJ, Castro-Acosta A, Melero Moreno M, Capelastegui A, Esteban C et al (2010) Clinical audit of patients admitted to hospital in Spain due to exacerbation of COPD (AUDIPOC Study): method and organization. Arch Bronconeumol 46:340–457CrossRef
29.
go back to reference Agarwal SK, Misra A, Aggarwal P et al (2009) Waist circumference measurement by site, posture, respiratory phase, and meal time: implications for methodology. Obesity 17:1056–1061PubMedCrossRef Agarwal SK, Misra A, Aggarwal P et al (2009) Waist circumference measurement by site, posture, respiratory phase, and meal time: implications for methodology. Obesity 17:1056–1061PubMedCrossRef
30.
go back to reference Agustí A, Edwards LD, Rennard SI, MacNee W, Tal-Singer R, Miller BE et al (2012) Persistent systemic inflammation is associated with poor clinical outcomes in COPD: a novel phenotype. PLoS ONE 7(5):e37483PubMedCentralPubMedCrossRef Agustí A, Edwards LD, Rennard SI, MacNee W, Tal-Singer R, Miller BE et al (2012) Persistent systemic inflammation is associated with poor clinical outcomes in COPD: a novel phenotype. PLoS ONE 7(5):e37483PubMedCentralPubMedCrossRef
31.
go back to reference Fabbri LM, Beghe B, Agustí A (2012) COPD and the solar system. Introducing the chronic obstructive pulmonary disease comorbidome. Am J Respir Crit Care Med 186:117–119PubMedCrossRef Fabbri LM, Beghe B, Agustí A (2012) COPD and the solar system. Introducing the chronic obstructive pulmonary disease comorbidome. Am J Respir Crit Care Med 186:117–119PubMedCrossRef
33.
go back to reference Clini E, Crisafulli E, Radaeli A, Malerba M (2011) COPD and the metabolic syndrome: an intriguing association. Int Emerg Med 2011 Oct 2 [Epub ahead of print] Clini E, Crisafulli E, Radaeli A, Malerba M (2011) COPD and the metabolic syndrome: an intriguing association. Int Emerg Med 2011 Oct 2 [Epub ahead of print]
34.
go back to reference Malerba M, Romanelli G (2009) Early cardiovascular involvement in chronic obstructive pulmonary disease. Monaldi Arch Chest Dis 71:59–65PubMed Malerba M, Romanelli G (2009) Early cardiovascular involvement in chronic obstructive pulmonary disease. Monaldi Arch Chest Dis 71:59–65PubMed
Metadata
Title
COPD patients with and without metabolic syndrome: clinical and functional differences
Authors
Jesús Díez-Manglano
José Barquero-Romero
Pedro Almagro
Francisco Javier Cabrera
Francisco López García
Lorena Montero
Joan Baptiste Soriano
Working Group on COPD; Spanish Society of Internal Medicine
Publication date
01-06-2014
Publisher
Springer Milan
Published in
Internal and Emergency Medicine / Issue 4/2014
Print ISSN: 1828-0447
Electronic ISSN: 1970-9366
DOI
https://doi.org/10.1007/s11739-013-0945-7

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