Metabolic syndrome in hospitalized patients with chronic obstructive pulmonary disease

Abstract

The metabolic syndrome (MS) affects 21-53% of patients with chronic obstructive pulmonary disease (COPD) with a higher prevalence in the early stages of COPD, with results being highly variable between studies. MS may also correlate with disease characteristics. The aim of the study is to examine the prevalence of MS and its correlation with comorbidities and COPD characteristics in patients with COPD admitted for exacerbation. 152 patients with COPD admitted for exacerbation were studied for presence of MS. All of them were also assessed for vitamin D status and diabetes mellitus type 2 (DM). Data were gathered for smoking status and exacerbations during the last year. All patients completed CAT (COPD assessment test) and mMRC (Modified Medical Research Council Dyspnea scale) questionnaires and underwent spirometry. Duration of current hospital stay was recorded. 25% of patients have MS. 23,1% of the male and 29,5% of the female patients have MS (p>0.05). The prevalence of MS in this study is significantly lower when compared to a national representative study (44,6% in subjects over 45 years). 69,1% of all patients and 97,4% from MS patients have arterial hypertension. The presence of MS is associated with significantly worse cough and sleep (1st and 7th CAT questions; p=0.002 and p=0.001 respectively) and higher total CAT score (p=0.017). Average BMI is 27,31. None of the patients have MS and BMI <25. There is a correlation between the presence of MS and DM (p=0.008) and with the number of exacerbations in the last year (p=0.015). There is no correlation between the presence of MS and the pulmonary function. This study among hospitalized COPD patients finds comparable but relatively low prevalence of MS (25%) compared to previously published data (21-53%) and lower prevalence compared to general population (44,6%). MS may impact natural course and the number of exacerbations of COPD. Having in mind that MS is more common in the early stages and decreases with COPD progression, the COPD patients admitted for exacerbation may be considered as having advanced COPD.

A study to investigate the prevalence of metabolic syndrome in Chronic Obstructive Pulmonary Disease patients from North India

“…Mekov E et al, found in their study that 15.8% of patients were never smokers, 57.9% ex-smokers and 26.3% current smokers. 39 In present study, maximum proportions of smokers were in GOLD stage-3 (70.6%) followed by stage-2 (60%) followed by stage-4 (57.1%) and in GOLD stage-1 smokers were 40% but the difference was not significant (p>0.05). Helvaci MR et al, had done study among COPD patients and found the prevalence of smoking in mild, moderate and severe COPD groups were 79.3%, 73.2%, 58.8% respectively.…”

“…38 Mekov E et al, in their study had observed, mean age of patients was 65±10 years in which 71.1% were males, 28.9% were females. 39 In present study majority of males were ex-tobacco smokers (46.3%) followed by tobacco smokers (13.4%) and 11.1% of males were non-smokers. All females were non-smokers (tobacco).…”

“…They further concluded that 25% patients with COPD have features of metabolic syndrome. 39 Amreen NM et al, had done a study to know the incidence of metabolic syndrome among 70 stable COPD patients and 20 healthy controls. They further highlighted that incidence of metabolic syndrome in mild, moderate, severe and very severe COPD groups were 11.1%, 34.8%, 25% and 50% respectively.…”

Comorbidities of COPD in Bulgarian Patients – Prevalence and Association with Severity and Inflammation

“…23 Study performed in Korea among 133 newly diagnosed patients with COPD reports similar results -prevalence of MS of 36.8%. 24 In Bulgaria, Mekov et al found 25% prevalence of MS in 155 COPD patients 25 , and epidemiological study in Pleven region, Bulgaria found MS in 13.8% of the investigated 3598 COPD patients. The lower prevalence reported in the latter study could be explained with using the body mass index (BMI) instead of waist circumference as a major criterion for defi ning MS. 26 These studies show that metabolic syndrome is 1.3-1.5-times more common in COPD patients than in people with normal lung function.…”

Comorbidities and their impact on chronic obstructive pulmonary disease

“…Metabolic Syndrome and abdominal obesity is more prevalent in mild to moderate COPD (16-24%) than severe disease (6%) (26). In early COPD, obesity can induce cardiovascular mortality but in the late stages of disease, the cachexia takes place and associated with increased mortality (27).…”