Metabolic syndrome and Chronic Obstructive Pulmonary Disease (COPD): The interplay among smoking, insulin resistance and vitamin D

Piazzolla, Giuseppina; Castrovilli, Anna; Liotino, Vito; Vulpi, Maria Rosaria; Fanelli, Margherita; Mazzocca, Antonio; Candigliota, Mafalda; Berardi, Elsa; Resta, Onofrio; Sabbá, Carlo; Tortorella, Cosimo

doi:10.1371/journal.pone.0186708

Cited by 41 publications

(35 citation statements)

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“…We also demonstrated that the increased risk of NAFLD with decreased lung function is irrespective of whether the subjects were smokers or never smokers. Furthermore, emerging evidence has shown that both NAFLD and impaired lung function were commonly associated with cardio-metabolic comorbidities [5,34–36]. Therefore, NAFLD and impaired lung function could be associated not by chance but by pathobiological necessity [37].…”

Section: Discussionmentioning

confidence: 99%

Decreased lung function is associated with risk of developing non-alcoholic fatty liver disease: A longitudinal cohort study

et al. 2019

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BackgroundDecreased lung function is associated with non-alcoholic fatty liver disease (NAFLD), based on linking mechanisms such as insulin resistance and systemic inflammation However, its association with the risk of developing NAFLD is unclear. Our aim was to investigate whether baseline lung function is associated with incident NAFLD in middle-aged healthy Koreans.MethodsA cohort study of 96,104 subjects (mean age: 35.7 years) without NAFLD were followed up from 2002 to 2015. NAFLD was diagnosed by ultrasound after the exclusion of other possible causes of liver diseases. Baseline percent predicted forced expiratory volume in one second (FEV1%) and forced vital capacity (FVC%) were categorized in quartiles. Adjusted hazard ratios (aHR) and 95% confidence intervals (CIs) (using the highest quartile as reference) were calculated for incident NAFLD at follow-up, controlling for covariates and potential confounders.ResultsDuring 579,714.5 person-years of follow-up, 24,450 participants developed NAFLD (incidence rate, 42.2 per 1,000 person-years). The mean follow-up period was 5.9±3.4 years. Regardless of smoking history, the risk for incident NAFLD increased with decreasing quartiles of FEV1 (%) and FVC (%) in a dose-response manner (p for trend<0.001). In never smokers, the aHRs (95% CIs) for incident NAFLD were 1.15 (1.08–1.21), 1.11 (1.05–1.18), and 1.08 (1.02–1.14) in quartiles 1–3 for FEV1 (%) and 1.12 (1.06–1.18), 1.11 (1.05–1.18), and 1.09 (1.03–1.15) in quartiles 1–3 for FVC (%), compared with the highest quartile reference. Similar inverse association was present in smoke-exposed subjects (aHR for incident NAFLD were 1.14, 1.21, 1.13 and 1.17, 1.11, 1.09 across FEV1(%) and FVC(%) quartile in increasing order, respectively).ConclusionsReduced lung function was a risk factor for incident NAFLD in a large middle-aged Korean cohort with over half a million person-years of follow-up.

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Section: Discussionmentioning

confidence: 99%

Decreased lung function is associated with risk of developing non-alcoholic fatty liver disease: A longitudinal cohort study

et al. 2019

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“…A particularly interesting point emerged from the analysis of the smoking habit variable, as cigarette smoke is described to induce both insulin resistance [27] and Hcy production [8]. The group with high Hcy displayed higher values of pack-years and a greater percentage of smoking individuals (including both ex-smokers and current smokers) as compared with the other subset.…”

Section: Discussionmentioning

confidence: 99%

Hyperhomocysteinemia is an independent risk factor of atherosclerosis in patients with metabolic syndrome

Piazzolla

Candigliota

Fanelli

et al. 2019

Diabetol Metab Syndr

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BackgroundMetabolic syndrome (MetS) is a clinical condition potentially promoting the development of atherosclerotic disease. To date, the clinical impact of elevated serum homocysteine (Hcy) levels in MetS is still under discussion. The aim of this cross sectional study was to evaluate the relationship between MetS and hyperhomocysteinemia and the potential role of Hcy in the pathogenesis of atherosclerotic complications of MetS.MethodsWe recruited 300 outpatients with MetS. All patients underwent a medical history collection, physical examination, blood sampling and carotid ultrasound echo-color Doppler. According to Hcy levels, MetS patients were divided into two groups: “normal” (< 10.7 μmol/l; n = 140, group 1) and “high” Hcy (≥ 10.7 μmol/l; n = 160, group 2). Comparisons between groups were made by Student’s t-test or Chi-square test. The effects of potential covariates on group differences were evaluated by general linear models. The relationships between continuous variables were assessed by simple or multiple correlation and by linear regression. Multiple regression models were built to evaluate the effects of Hcy, together with other potential risk factors, on carotid atherosclerosis.ResultsPatients with high Hcy were predominantly male and slightly older than group 1 patients. Smokers and non-smokers exhibited similar Hcy levels, nor was a statistical relationship between pack-years and Hcy observed. Group 2 showed lower levels of folic acid, vitamin D, high density lipoprotein (HDL)-cholesterol and glomerular filtration rate (e-GFR) than group 1, but higher levels of C-peptide, uric acid and triglycerides. In all patients, Hcy was positively correlated with C-peptide and uric acid and negatively with folic acid and e-GFR. Intima-media thickness (IMT) and carotid stenosis degree were significantly higher in patients with high Hcy and a positive relationship between Hcy and both IMT and carotid stenosis was detected in all patients. Finally, Hcy atherogenic effects were independent of other well-known atherosclerosis risk factors.ConclusionsOur results highlight a link between MetS and hyperhomocysteinemia and a direct effect of Hcy on atherogenic process during MetS. Early correction of folic acid levels may contribute to prevent cardiovascular complications in MetS patients.

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“…[16] G. Piazzolla and Castrovilli A have found that 62% of COPD patients had metabolic syndrome. [17] In their study they used the “harmonizing definition” of the syndrome by Alberti et al [18] for diagnosing metabolic syndrome. An Indian study reported a prevalence of Metabolic Syndrome of 33% using the IDF criteria and a prevalence of 15.56% using NCEP ATP III criteria in the same study population.…”

Section: Discussionmentioning

confidence: 99%

“…[8] In contrast to our finding, in a study by Piazollo G, it was found that Serum vitamin D levels were not different among Metabolic syndrome, COPD and Metabolic syndrome with COPD groups. [17]…”

Section: Discussionmentioning

confidence: 99%

Systemic inflammation in patients of chronic obstructive pulmonary disease with metabolic syndrome

Naseem

Baneen

2019

J Family Med Prim Care

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Context:India has 18% of the global population and an increasing burden of chronic respiratory diseases. The prevalence of Metabolic syndrome (MS) was found to be as high as 39.7% among Indian population. Metabolic syndrome is found to be more common in Chronic Obstructive Pulmonary Disease (COPD) when compared to the general population. This study was done to assess the prevalence of metabolic syndrome in COPD and the association of systemic inflammation in COPD patients with metabolic syndrome.Methodology:This study enrolled 150 consecutive consenting patients of stable COPD attending the outpatient pulmonology department. Detailed history, clinical examination, spirometry, and relevant routine laboratory investigations including complete blood count, fasting blood sugar, and lipid profile were done. In addition, hsCRP, Serum lactate and Vitamin D level was assessed in all patients. Diagnosis of COPD and Metabolic syndrome was done according to GOLD guidelines, 2018 and the International Diabetes Federation criteria respectively.Result:The prevalence of metabolic syndrome was found to be 27.3% in our COPD patients. The frequency of metabolic syndrome in GOLD stage I, II, III, and IV was 75%, 32%, 17%, and 13.5%, respectively. Logistic regression analysis showed a significant relationship of blood leucocyte count (OR = 0.342, CI = 0.171-0.686), hs-CRP (OR = 0.020, CI = 0.003-0.122), pack years (OR = 1.083, CI = 1.026-1.14) and vitamin D levels (OR = 1.219, CI = 1.093-1.359) with metabolic syndrome in COPD patients.Conclusion:Metabolic syndrome is a co-morbidity that is very often overlooked in patients of COPD. Systemic inflammation which is a common characteristic of both COPD and Metabolic syndrome has been found to be an important contributor towards cardiovascular morbidity and mortality.

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Metabolic syndrome and Chronic Obstructive Pulmonary Disease (COPD): The interplay among smoking, insulin resistance and vitamin D

Cited by 41 publications

References 45 publications

Decreased lung function is associated with risk of developing non-alcoholic fatty liver disease: A longitudinal cohort study

Decreased lung function is associated with risk of developing non-alcoholic fatty liver disease: A longitudinal cohort study

Hyperhomocysteinemia is an independent risk factor of atherosclerosis in patients with metabolic syndrome

Systemic inflammation in patients of chronic obstructive pulmonary disease with metabolic syndrome

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