Comorbidities and mortality risk in adults younger than 50 years of age with chronic obstructive pulmonary disease

Abstract

Rationale and objective Patients with chronic obstructive pulmonary disease (COPD), usually diagnosed after the 6th decade, frequently suffer from comorbidities. Whether COPD patients 50 years or younger (Young COPD) have similar comorbidities with the same frequency and mortality impact as aged-matched controls or older COPD patients is unknown. Methods We compared comorbidity number, prevalence and type in 3 groups of individuals with ≥ 10 pack-years of smoking: A Young (≤ 50 years) COPD group (n = 160), an age-balanced control group without airflow obstruction (n = 125), and Old (> 50 years) COPD group (n = 1860). We also compared survival between the young COPD and control subjects. Using Cox proportional model, we determined the comorbidities associated with mortality risk and generated Comorbidomes for the “Young” and “Old” COPD groups. Results The severity distribution by GOLD spirometric stages and BODE quartiles were similar between Young and Old COPD groups. After adjusting for age, sex, and pack-years, the prevalence of subjects with at least one comorbidity was 31% for controls, 77% for the Young, and 86% for older COPD patients. Compared to controls, “Young” COPDs’ had a nine-fold increased mortality risk (p < 0.0001). “Comorbidomes” differed between Young and Old COPD groups, with tuberculosis, substance use, and bipolar disorders being distinct comorbidities associated with increased mortality risk in the Young COPD group. Conclusions Young COPD patients carry a higher comorbidity prevalence and mortality risk compared to non-obstructed control subjects. Young COPD differed from older COPD patients by the behavioral-related comorbidities that increase their risk of premature death.

Association of TNFα -308G/A and IL10 -1082A/G Polymorphisms with Pulmonary Tuberculosis Susceptibility in a Brazilian population

“…Its has been related to intrinsic sex aspects, such as habits and lifestyle, which promote Mtb bacillus exposition, thus, increasing disease incidence in men individuals [30,32,33]. These results corroborate with the literature, which demonstrate that in the developing countries, such as Brazil, 80% of individuals with active tuberculosis are in age group 15-59 years old, the age group of highest social productivity, consequently, elevated exposition to Mtb [1,31,33].…”

“…The developing of pulmonary tuberculosis (PTB) is based on several risk factors, mainly that related to socioeconomic, behavioral, and biologic aspects [2,3,10,30,31]. Thus, this study performed multiple factors analyses, including sociodemographic, clinical, epidemiological, and genetic variables, in an admixture Brazilian population to evaluate their possible association with PTB susceptibility.…”

Prevalence, risk factors, and mortality of COPD in young people in the USA: results from a population-based retrospective cohort

“…Previous studies showed that COPD in young people who were often undiagnosed had significant structural and functional abnormalities 5. Compared with healthy controls without airflow limitation, young COPD showed an increased risk of exacerbations6 and has a higher comorbidity prevalence and mortality risk 7 8. Therefore, COPD in young people is worthy of extensive attention and research.…”

“…Another study described the characteristics of ‘early COPD’ in the Copenhagen population,7 but its diagnosis of ‘COPD’ was according to pre-bronchodilator spirometry. Additionally, a previous study merely enrolled smokers under the age of 50 years old and the results could not be generalised to the whole population 8. Therefore, the prevalence and clinical characteristics of COPD in young people cannot be accurately assessed.…”

EPOC en jóvenes: Comorbilidades y riesgo de mortalidad

“…Divo y el grupo de BODE mencionan en su artículo, que los pacientes jóvenes con EPOC tienen una alta carga de comorbilidades, algunas de las cuales son específicamente frecuentes en este grupo diagnóstico [18]. Estas morbilidades confieren un mayor riesgo de muerte a esta temprana edad.…”