Chronic Obstructive Pulmonary Disease (COPD) as a risk factor for Metabolic Syndrome (MetS)
Date Issued
2020-12
Author(s)
Trajkovska, Ivana
Buklioska, Adriana
Abstract
Background: MetS represents a cluster of risk factors (abdominal obesity, atherogenic
dyslipidemia, hypertension and insulin resistance) that predispose affected patients
to systemic inflammation, cardiovascular disease and physical inactivity. COPD is a
major health problem worldwide, the fourth leading cause of death with prevalence
in increase. There is a limited data about the prevalence of MetS in COPD. The aim of
the study is to determine the frequency of coexisting MetS in COPD.
Methods: Case control study of 120 patients with COPD (82 men and 38 women,
aged 40-75 years, mean age 64.2±10.4), diagnosed according to Global Initiative for
Chronic Obstructive Lung Disease, 30 healthy non-COPD subjects, randomly selected
as controls. Anthropometric measurements, fasting blood sugar (FBS), lipid profile,
high-sensitivity C-reactive protein (hsCRP), spirometry, CAT (COPD assessment test)
and mMRC (Modified Medical Research Council Dyspnea scale) questionnaires, were
assessed. COPD subjects were stratified based on combined assessment test (ABCD
criteria) and spirometry (stages I - IV).
Results: The presence of MetS was diagnosed in 50(41.67%) of COPD patients vs.
5(16.67%) of controls (p=0.01). The frequencies of the MetS in patients with COPD,
GOLD stages I, II, III, and IV, were 50(41,67%), 66(55%), 60(50%), 42(35%) respectively.
Frequency of MetS according to combined assessment test (A, B, C, D) was 42(35%),
54(45%), 25(30%), 36(30%) respectively. The presence of MetS was associated with
significantly worse cough, sleep and mood (p<0.01) and higher total CAT score
(p=0.031). Average BMI was 29.18. There was a correlation between the presence of
MetS and hs-CRP (p=0.02) and no correlation with the pulmonary function. FBS was
higher in COPD than controls (8.5±1.2mmol/L vs 5.4±1.1mmol/L) with statistical
significance (p<0.0001), but HDL was lower in COPD than controls (42.1±5.4mg/dl vs
53±3.6mg/dl) with statistical significance (p<0.0001). Waist circumference and blood
pressure were higher in COPD than controls 93.8s±2.4m vs. 92.3±3.1sm, p=0.004, and
mean systolic BP 135±10mmHg vs. 113.5±8.1mmHg, p < 0.0001.
Conclusion: The high prevalence of MetS in patients with COPD show the urgent need
to develop comprehensive strategies for prevention, screening and start of treatment
in early stage. Correction of the MetS may have a significant role in prevention of
complications related with the COPD.
dyslipidemia, hypertension and insulin resistance) that predispose affected patients
to systemic inflammation, cardiovascular disease and physical inactivity. COPD is a
major health problem worldwide, the fourth leading cause of death with prevalence
in increase. There is a limited data about the prevalence of MetS in COPD. The aim of
the study is to determine the frequency of coexisting MetS in COPD.
Methods: Case control study of 120 patients with COPD (82 men and 38 women,
aged 40-75 years, mean age 64.2±10.4), diagnosed according to Global Initiative for
Chronic Obstructive Lung Disease, 30 healthy non-COPD subjects, randomly selected
as controls. Anthropometric measurements, fasting blood sugar (FBS), lipid profile,
high-sensitivity C-reactive protein (hsCRP), spirometry, CAT (COPD assessment test)
and mMRC (Modified Medical Research Council Dyspnea scale) questionnaires, were
assessed. COPD subjects were stratified based on combined assessment test (ABCD
criteria) and spirometry (stages I - IV).
Results: The presence of MetS was diagnosed in 50(41.67%) of COPD patients vs.
5(16.67%) of controls (p=0.01). The frequencies of the MetS in patients with COPD,
GOLD stages I, II, III, and IV, were 50(41,67%), 66(55%), 60(50%), 42(35%) respectively.
Frequency of MetS according to combined assessment test (A, B, C, D) was 42(35%),
54(45%), 25(30%), 36(30%) respectively. The presence of MetS was associated with
significantly worse cough, sleep and mood (p<0.01) and higher total CAT score
(p=0.031). Average BMI was 29.18. There was a correlation between the presence of
MetS and hs-CRP (p=0.02) and no correlation with the pulmonary function. FBS was
higher in COPD than controls (8.5±1.2mmol/L vs 5.4±1.1mmol/L) with statistical
significance (p<0.0001), but HDL was lower in COPD than controls (42.1±5.4mg/dl vs
53±3.6mg/dl) with statistical significance (p<0.0001). Waist circumference and blood
pressure were higher in COPD than controls 93.8s±2.4m vs. 92.3±3.1sm, p=0.004, and
mean systolic BP 135±10mmHg vs. 113.5±8.1mmHg, p < 0.0001.
Conclusion: The high prevalence of MetS in patients with COPD show the urgent need
to develop comprehensive strategies for prevention, screening and start of treatment
in early stage. Correction of the MetS may have a significant role in prevention of
complications related with the COPD.
Subjects
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