COPD and the metabolic syndrome: an intriguing association

Abstract

Chronic Obstructive Pulmonary Disease (COPD) has been recently recognized as a condition involving more than the lungs. The presence of common factors in COPD and in other chronic extra-pulmonary diseases, as well as the co-existence of these conditions in the same adult individual, supports the hypothesis of a shared pathogenetic pathway. We will here review the interplay between coexisting COPD and the metabolic syndrome (MS), based on the most updated knowledge. We will discuss this clinical condition from the definition, to the pathophysiology and to the clinical implications. Basically, MS is more likely to be present in a COPD patients, and increased levels of circulatory pro-inflammatory proteins from both the lung and adipose tissue coincide in these patients. The relative impact of the coexisting COPD and MS may depend on several factors: the presence of physical inactivity and of systemic inflammation related to a smoking habit, sedentary lifestyle, airway inflammation and obstruction, adipose tissue and inflammatory marker activation. More studies will be required to elucidate the association between COPD and MS and to formulate individualized management approaches for this specific disease phenotype.

Chronic obstructive pulmonary disease and the metabolic syndrome: Consequences of a dual threat

“…[5051] The risk factors for developing COPD and MetS are found to be similar in many ways. The important risk factors which linking the pathogenic mechanism between COPD and MetS are smoking, genetics, obesity, physical inactivity, and airflow limitation.…”

“…The pathogenic mechanisms linking risk factors and development of COPD and metabolic syndrome are shown in the Figure 1. [50]…”

Efficacy of Atorvastatin Plus Amlodipine Combination in Patients With Chronic Obstructive Pulmonary Disease and Comorbid Metabolic Syndrome

“…У больных ХОБЛ + МС был отмечен высокий уровень лептина, что подтверждается результатами исследований зарубежных авторов, указывающих на роль адипоцитокинов в патогенезе ХОБЛ и абдоми-нального типа ожирения как компонента МС [2,7].…”

“…Многочисленные исследова-ния показали взаимосвязь между системным воспалением и нарушением обмена веществ у боль-ных ХОБЛ [2,[4][5][6]. Распространенность метаболи-ческого синдрома (МС) среди больных ХОБЛ, осо-бенно на ранних ее стадиях, составляет 21-53 % [7,8]. Увеличение числа случаев МС среди больных ХОБЛ может быть связано с повышением распрост-раненности ожирения, уменьшением физической активности, курением, использованием кортикосте-роидов, а также с наличием при указанной пато-логии таких важных механизмов патологического процесса, как воспаление, окислительный стресс и гипоксия [6,8,9].…”

Severity of heart failure and risk of incident diabetes: a reverse causation?

“…Thus, the dosage of loop diuretic might be a proxy for metabolic disorder severity rather than heart failure severity. The higher proportion of patients with atrial flutter/ fibrillation, chronic obstructive pulmonary disease and renal disease in the higher diuretic dosage groups shown in Table 1 of the paper by Demant et al [1] not only frequently coexists with more severe heart failure, but also closely associates with more serious metabolic syndrome [6,7]. Thus, it is not clear whether more severe heart failure or more severe metabolic syndrome underlies the increased risk of diabetes in the patients receiving the higher diuretic dosage.…”