An increase in atrogin-1 and MuRF1 mRNA and FoxO-1 protein content was observed in the quadriceps of patients with COPD. The transcriptional regulation of atrogin-1 and MuRF1 may occur via FoxO-1, but independently of AKT. The overexpression of the muscle hypertrophic signaling pathways found in patients with COPD with muscle atrophy could represent an attempt to restore muscle mass.
Introduction With the growing burden of chronic diseases, surveillance will play an essential role in improving their prevention and control. The Institut national de santé publique du Québec has developed an innovative chronic disease surveillance system, the Quebec Integrated Chronic Disease Surveillance System (QICDSS). We discuss the primary features, strengths and limitations of this system in this report. Methodology The QICDSS was created by linking five health administrative databases. Updated annually, it currently covers the period from January 1, 1996, to March 31, 2012. The operational model comprises three steps: (1) extraction and linkage of health administrative data according to specific selection criteria; (2) analysis (validation of case definitions essentially) and production of surveillance measures; and (3) data interpretation, submission and dissemination of information. The QICDSS allows the surveillance of the following chronic diseases: diabetes, cardiovascular diseases, respiratory diseases, osteoporosis, osteoarticular diseases, mental disorders, Alzheimer's disease and related disorders. The system also lends itself to the analysis of multimorbidity and polypharmacy. Results For 2011–2012, the QICDSS contained information on 7 995 963 Quebecers with an average age of 40.8 years. Of these, 95.3% met at least one selection criterion allowing the application of case definitions for chronic disease surveillance. The actual proportion varied with age, from 90.1% for those aged 19 years or less to 99.3% for those aged 65 years or over. Conclusion The QICDSS provides a way of producing population-based data on the chronic disease burden, health services and prescription drug uses. The system facilitates the integrated study of several diseases in combination, an approach rarely implemented until now in the context of population surveillance. The QICDSS possesses all the essential features of a surveillance system and supports the dissemination of information to public health decision-makers for future actions.
Background: Overweight and obesity have been associated with better survival in patients with chronic obstructive pulmonary disease (COPD). On the other hand, excess body weight is associated with abnormal metabolic and inflammatory profiles that define the metabolic syndrome and predispose to cardiovascular diseases. This study was undertaken to evaluate the impact of overweight and obesity on the prevalence of the metabolic syndrome and on the metabolic and inflammatory profiles in patients with COPD. Methods: Twenty-eight male patients with COPD were divided into an overweight/obese group [n ϭ 16, body mass index (BMI) ϭ 33.5 Ϯ 4.2 kg/m 2 ] and normal weight group (n ϭ 12, BMI ϭ 21.1 Ϯ 2.6 kg/m 2 ). Anthropometry, pulmonary function and body composition were assessed. The metabolic syndrome was diagnosed according to waist circumference, circulating levels of triglyceride and high-density lipoprotein cholesterol levels, fasting glycemia and blood pressure. C-reactive protein, tumor necrosis factor-␣ (TNF-␣), interleukin-6 (IL-6), leptin and adiponectin plasma levels were measured. Results: Airflow obstruction was less severe in overweight/obese compared with normal weight patients (forced expiratory volume 1 : 51 Ϯ 19% versus 31 Ϯ 12% predicted, respectively, P Ͻ 0.01). The metabolic syndrome was diagnosed in 50% of overweight/obese patients and in none of the normal weight patients. TNF-␣, IL-6 and leptin were significantly higher in overweight/obese patients whereas the adiponectin levels were reduced in the presence of excess weight. Conclusions:The metabolic syndrome was frequent in overweight/obese patients with COPD. Obesity in COPD was associated with a spectrum of metabolic and inflammatory abnormalities. (61%) of the metabolic syndrome in men with COPD participating to a pulmonary rehabilitation program. 13 In comparison, the reported prevalence of the metabolic syndrome in age-matched men without COPD is 44%. 14 Lastly, COPD may predispose to insulin resistance and type-II diabetes. 15 It therefore emerges that, although obesity may protect against mortality on the short term, the concomitant presence of COPD and obesity may define a clinical phenotype at a high risk for cardiovascular diseases. Before making recommendation about weight management in COPD, there is a need to better understand the implication of obesity in this specific patient population. We hypothesized that in the presence of overweight/ obesity, patients with COPD would exhibit a metabolic and inflammatory profile associated with a higher risk of cardiovascular diseases. This hypothesis was tested by evaluating the prevalence of the metabolic syndrome and characterizing the metabolic and inflammatory profile in overweight/obese patients with COPD in comparison to normal weight patients with COPD. Methods Subject characteristicsTwenty-eight male patients with COPD volunteered to participate in the study. These patients were recruited consecutively from a cohort of patients previously engaged in pulmonary rehabilitation in our inst...
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