Characteristics and self-rated health of overlap syndrome

Abstract

Background and objectiveOverlap syndrome shares features of both asthma and chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate characteristics of overlap syndrome and their effect on self-rated health (SRH).MethodsWe analyzed data from the Fourth Korea National Health and Nutrition Examination Survey of 2007–2009. Subjects with acceptable spirometry and available wheezing history were included. Subjects were classified into four groups based on forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) results and the presence or absence of self-reported wheezing for the previous 12 months: 1) COPD group, defined as having FEV1/FVC <0.7 without self-reported wheezing history; 2) asthma group, defined as having self-reported wheezing history without FEV1/FVC <0.7; 3) overlap syndrome group, having both FEV1/FVC <0.7 and wheezing history; and 4) non-obstructive disease (NOD) group, having neither FEV1/FVC <0.7 nor self-reported wheezing. SRH was categorized as better or lower based on responses to a questionnaire.ResultsFrom a total 9,104 subjects, 700 were assigned to the COPD group, 560 to the asthma group, 210 to the overlap syndrome group, and 7,634 to the NOD group. Compared to the other groups, subjects in the overlap syndrome group were more likely to have low lung function, a high proportion of smokers, low socioeconomic status, short education duration, lower SRH, and past diagnosis of pulmonary tuberculosis or bronchiectasis. Multiple logistic regression analysis revealed that both overlap syndrome and asthma groups were independently associated with lower SRH after adjustment for age, sex, socioeconomic status, education level, smoking status, comorbidities, and lung function. Female, old age, low education level, low economic status, smoker and other comorbidities were also associated with lower SRH.ConclusionOverlap syndrome was accompanied by high morbidity and was associated with lower SRH, which needs more appropriate care.

Identifying possible asthma–COPD overlap syndrome in patients with a new diagnosis of COPD in primary care

“…In keeping with this, patients classified into the ACOS group by this definition had more dyspnoea compared with the COPD-only group. Using the same criteria, although in a cross-sectional population study, Chung et al 28 found a prevalence of ACOS of 2.3% in the total population, corresponding to a prevalence of 30% in the COPD group, similar to the findings in the present study. Furthermore, Huang et al 29 have recently reported that the presence of episodic wheezing in patients with COPD has a negative impact on morbidity.…”

Gender and asthma-chronic obstructive pulmonary disease overlap syndrome

“…Comorbidities have been reported to be more common in ACOS than COPD [19,25] and asthma [11,19]. It is known that COPD alone increases the risk of comorbidities [43,44].…”

“…According to new guidelines, this overlap syndrome is characterized by persistent airflow limitation with several features of both asthma and COPD [7,8]. Among published studies, persons labeled with this overlap syndrome are reported to experience more frequent healthcare utilization and severe impairment than persons with COPD [3,5,6,9–12] or asthma alone [6,11,12]. …”

“…Women appear to be susceptible to developing COPD earlier, exhibit greater bronchial reactivity, and experience poorer health status than men with the same tobacco exposure [17,18]. Some, but not all, studies have reported ACOS to be more common in women; however, no studies have primarily focused on the role of gender in ACOS as compared to asthma or COPD [6,10,11,19]. The aim of this analysis is to describe the sociodemographic characteristics of persons with asthma, COPD, and ACOS and compare the frequency of respiratory symptoms, health impairment, and comorbidities in relationship to gender in a state’s general adult population.…”

Ashtma-Chronic obstructive pulmonary disease overlap syndrome (ACOS): current evidence and future research directions

“…However, others found that ACOS is more likely to be associated with low lung function, low socioeconomic status, short education duration, lower self-rated health, and past diagnosis of pulmonary tuberculosis or bronchiectasis. Multiple logistic regression analysis revealed that both overlap syndrome and asthma groups were independently associated with lower self-rated health after adjustment for age, sex, socioeconomic status, education level, smoking status, comorbidities, and lung function [63]. ACOS appears to be associated with the poorest health-related quality of life (HRQL) [64].…”