Disease-Specific Comorbidity Clusters in COPD and Accelerated Aging

Abstract

Background: Patients with chronic obstructive pulmonary disease (COPD) often suffer from multiple morbidities, which occur in clusters and are sometimes related to accelerated aging. This study aimed to assess the disease specificity of comorbidity clusters in COPD and their association with a biomarker of accelerated aging as a potential mechanistic factor. Methods: Body composition, metabolic, cardiovascular, musculoskeletal, and psychological morbidities were objectively evaluated in 208 COPD patients (age 62 ± 7 years, 58% males, FEV1 50 ± 16% predicted) and 200 non-COPD controls (age 61 ± 7 years, 45% males). Based on their presence and severity, the morbidities were clustered to generate distinct clusters in COPD and controls. Telomere length in circulating leukocytes was compared across the clusters. Results: (co)morbidities were more prevalent in COPD patients compared to controls (3.9 ± 1.7 vs. 2.4 ± 1.5, p < 0.05). A “Psychologic” and “Cachectic” cluster were only present in the COPD population. “Less (co)morbidity”, “Cardiovascular”, and “Metabolic” clusters were also observed in controls, although with less complexity. Telomere length was reduced in COPD patients, but did not differ between the (co)morbidity clusters in both populations. Conclusions: Two COPD-specific comorbidity clusters, a “Cachectic” and “Psychologic” cluster, were identified and warrant further studies regarding their development. Accelerated aging was present across various multimorbidity clusters in COPD.

FKBP5 Polymorphism, Coping and Emotional Status in Chronic Obstructive Pulmonary Disease Patients Undergoing Pulmonary Rehabilitation

“…The number of real-life studies on COPD is increasing [75], but the amount of available data other than remission and/or exacerbations is limited. This study provides a multiperspective evaluation of COPD patients starting from a genetic make-up characterization, and provides a molecular basis in support of the theory by Triest et al [74], concerning the presence of a "Psychologic" comorbidity cluster, specific only for COPD patients. Moreover, the assessment of the QoL in a real-life setting is critical to estimate the adherence and the compliance to treatment.…”

“…Figure 2 summarizes the phenotype of subjects carrying rs4713916 evaluated in our study. Recently, a new study describes the presence of a specific "Psychologic" comorbidity cluster related to COPD not present in matching aging control population [74]. This cluster in respect to the clinical characterization, is distinguished by the worst QoL.…”

Prevalence of different comorbidities in chronic obstructive pulmonary disease among Shahrekord PERSIAN cohort study in southwest Iran

“…In the study of Negro, at least 76.6% of patients had one comorbidity, 68.8% had two comorbidities, and 47.9% had three or more comorbidities, and cardiovascular diseases were the most common disorders 38 . The review article of Corlateanu et al indicated that the most common comorbidities among COPD patients were ischemic heart disease, hyperlipidemia, congestive heart failure, diabetes, metabolic syndrome, osteoporosis, and depression 10 In a study conducted by Triest, atherosclerosis and dyslipidemia were the most common comorbidities in patients with COPD 39 . In the study of Mannino et al, which included 186,881 patients with COPD, the most common comorbidities were cardiovascular disease (34.8%), diabetes (22.8%), and asthma (14.7%).…”

From systemic effects of COPD to COPD as pulmonary component of multimorbidity

“…Alterations of developmental pathways including Notch, sonic hedgehog and Wnt signalling are found to be susceptibility factors for COPD through the regulation of stem cells 89 . Altered transcription, including telomeric attrition, may be more predominant in certain COPD phenotypes; however, a recent study found that accelerated ageing was present across comorbidity clusters in COPD, although the study might have been underpowered 93 .…”