COPD patients with and without metabolic syndrome: clinical and functional differences

Abstract

Chronic obstructive pulmonary disease (COPD) and the metabolic syndrome (MetS) are considered public health challenges of the 21st century. The coexistence of MetS in COPD patients and any clinical differences between COPD patients with and without MetS have not been extensively studied. We aimed to describe the clinical characteristics of patients with MetS and COPD. An observational, multicenter study of 375 patients hospitalized for a COPD exacerbation with spirometric confirmation was performed. We measured the components of the MetS and collected comorbidity information using the Charlson index and other conditions. Dyspnea, use of steroids, exacerbations, and hospitalizations were also investigated. The overall prevalence of MetS in COPD patients was 42.9 %, was more frequent in women (59.5 %) than men (40.8 %), p = 0.02, but with no differences in age and smoking history. COPD patients with MetS had greater % predicted FEV1, more dyspnea, and more comorbidity and used more inhaled steroids (all p < 0.05). Diabetes, osteoporosis, coronary artery disease, and heart failure were more frequent in patients with MetS. They had been hospitalized more frequently for any cause but not for COPD. In multivariate analysis, the presence of MetS was independently associated with greater FEV1, inhaled steroids use, osteoporosis, diabetes, and heart failure. MetS is a frequent condition in COPD patients, and it is associated with greater FEV1, more dyspnea, and more comorbidities.

The Prevalence of Metabolic Syndrome In Chronic Obstructive Pulmonary Disease: A Systematic Review

“…The later was also shown by many studies reporting the highest MetS prevalence in patients with GOLD stage II compared to higher GOLD stages (28,29,32,34,36). This observation could be due to a relatively higher influence of lifestyle on body composition and metabolic health in less advanced disease compared to COPD induced triggers on the wasting process in advanced disease (45).…”

“…These studies showed more inhaled or oral steroid use, more statin use, more beta-blockers use and more antihypertensives in the MetS group compared to the non-MetS group. No differences were found in use of anti-diabetics, insulin and long term oxygen therapy (28,30).…”

“…One study found no significant difference in sedentary time between the MetS group and non-MetS group (25), however, the other studies showed significantly reduced physical activity levels and lower activity intensity in the COPD patients with MetS compared to the patients without MetS (24,31). Medication use between MetS and nonMetS patients with COPD was reported in three studies (28,30,35). These studies showed more inhaled or oral steroid use, more statin use, more beta-blockers use and more antihypertensives in the MetS group compared to the non-MetS group.…”

“…Smoking status in MetS and non-MetS patients was reported in 5 studies (24,(28)(29)(30)35). Four studies found no significant difference (24,28,30,35) and one study showed significantly less smoking in the MetS group expressed by pack-years (29).…”

“…Four studies found no significant difference (24,28,30,35) and one study showed significantly less smoking in the MetS group expressed by pack-years (29). Physical activity level was assessed in three studies (24,25,31) by measuring the physical activity level with an accelerometer or by measuring the sedentary time.…”