Pulmonary Arterial Pressure Response During Exercise in COPD: A Correlation with C-Reactive Protein (hsCRP)

Varga, János; Pálinkás, Attila; Lajkó, Imre; Horváth, Ildikó; Boda, Krisztina; Somfay, Attila

doi:10.2174/1874306401610010001

Cited by 18 publications

(21 citation statements)

References 39 publications

(43 reference statements)

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“…Összességében az aerob testmozgás bármilyen intenzitáson jótékony hatással van a metabolikus szindróma összes komponensére túlsúlyos vagy elhízott betegek esetén [26][27][28][29].…”

Section: Megbeszélésunclassified

A krónikus obstruktív tüdőbetegség metabolikus következményei

Fekete

Fazekas-Pongor

Szöllösi

et al. 2021

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Összefoglaló. Bevezetés: Krónikus obstruktív tüdőbetegségben (COPD) az obesitas mellett a csökkent fizikai aktivitás nagymértékben fokozza a metabolikus szindróma kialakulásának valószínűségét. Célkitűzés: Kutatásunk célja volt felmérni a metabolikus szindróma prevalenciáját COPD-ben, valamint azt, hogy milyen mértékben függ össze az életkorral, a nemmel, a társbetegségekkel, a tüdőfunkció károsodásának mértékével, a tápláltsági állapottal, a fizikai terhelhetőséggel és az életminőséggel. Módszer: Keresztmetszeti vizsgálatot végeztünk az Országos Korányi Pulmonológiai Intézet Légzésrehabilitációs Osztályán fekvő betegek körében 2019. július 1. és december 31. között. A véletlenszerűen kiválasztott 300, 40 év feletti betegnek ismertük az antropometriai, légzésfunkciós vizsgálati eredményét és laboratóriumi paramétereit. Adatokat gyűjtöttünk a dohányzási szokásokról, az előző évi exacerbatiók számáról és a kortikoszteroidok használatáról is. Az életminőség mérésére a betegségspecifikus Szent György-féle Légzési Kérdőív magyar nyelvre validált változatát használtuk. A metabolikus szindrómát a Nemzetközi Diabetes Szövetség kritériumai alapján határoztuk meg. Eredmények: A metabolikus szindróma a betegek 72%-ánál fordult elő, férfi: 65,9% nő: 77,2% (p = 0,031). A metabolikus szindrómás betegek esetében rövidebb 6 perces sétatávolságot mértünk ([m] 250 [150–330] vs. 295 [162–360]; p = 0,384), és szignifikánsan több volt az előző évi exacerbatiók száma (3 [0–6] vs. 1 [1–2]; p<0,001) a nem metabolikus szindrómás betegekhez képest. A BMI-re történő stratifikáció után a metabolikus szindróma jelenléte nagyobb volt BMI≥25 kg/m2 esetén. A hasi elhízás, a magas vérnyomás, a hyperlipidaemia és a hyperglykaemia szignifikánsan gyakoribb volt BMI≥25 kg/m2 esetén (p<0,001). Következtetés: Eredményeink azt sugallják, hogy a metabolikus szindrómás betegekben megnő az együttes morbiditási index, különösen azok körében, akik túlsúlyosak vagy elhízottak. Ezért a COPD-s betegekben nagyon fontos időben felismerni és megfelelően kezelni a metabolikus szindrómát. Orv Hetil. 2021; 162(5): 185–191. Summary. Introduction: Both obesity and the lack of physical activity among chronic obstructive pulmonary disease (COPD) patients increase the risk of developing metabolic syndrome. Objective: The goal of our study was to assess the prevalence of metabolic syndrome among COPD patients and to examine its correlation with age, gender, comorbidities, lung function values, nutritional status, exercise capacity, and quality of life. Method: A cross-sectional study was performed at the Department of Pulmonary Rehabilitation of the Hungarian National Korányi Institute for Pulmonology between July 1st and December 31st, 2019. A total of 300 patients aged over 40 were selected at random. Anthropometric data were collected along with lung function values, laboratory parameters, smoking status, the number of exacerbations in the previous year, and the use of corticosteroids. Quality of life was measured by the validated Hungarian, COPD-specific Saint George Respiratory Questionnaire. Metabolic syndrome was defined according to the International Diabetes Federation criteria. Results: Metabolic syndrome affected 72% of COPD patients (male: 65.9%, female 77.2%; p = 0.031). In patients with metabolic syndrome, shorter 6-minute walking distance was measured ([m] 250 [150–330] vs. 295 [162–360]; p = 0.384) and the number of exacerbations in the previous year was significantly higher (3 [0–6] vs. 1 [1–2]; p<0.001) compared to patients with no metabolic syndrome. After stratification for BMI, metabolic syndrome was more frequent in the case of BMI≥25 kg/m2. Central adiposity, hypertension, hyperlipidemia, and hyperglycemia were also significantly more frequent among patients with BMI≥25 kg/m2 (p<0.001). Conclusion: Our results suggest that the co-morbidity index increases in patients with metabolic syndrome, especially in overweight or obese patients. Therefore, early detection and appropriate treatment of metabolic syndrome in patients with COPD is very important. Orv Hetil. 2021; 162(5): 185–191.

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Section: Megbeszélésunclassified

A krónikus obstruktív tüdőbetegség metabolikus következményei

Fekete

Fazekas-Pongor

Szöllösi

et al. 2021

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“…LTx is a potential treatment of end-stage severe pulmonary diseases such as COPD, ILD, Bronchiectasis, CF and PAH. We have to choose individual, closely controlled and supervised training programs for our patients, based on the different comorbidities and side effects of the advanced chronic respiratory diseases (PAH, dynamic hyperinflation) and permanent chronic inflammation (35)(36)(37)(38)(39)(40). Nutritional and functional status are impaired, and low physical activity levels can be detected in advanced pulmonary diseases (41,42).…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of pulmonary rehabilitation in connection with lung transplantation in Hungary

Kerti¹,

Bohács²,

Madurka³

et al. 2021

Ann Palliat Med

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Background: The role of pre-and post-lung transplant rehabilitation is to maintain or improve exercise tolerance, lung mechanics, peripheral and respiratory muscle function. Our aim was to measure the effectiveness of pre-and post-transplant rehabilitation in terms of the changes of functional and quality of life markers. Methods: Sixty-three patients (40 COPD FEV1: 21±5 %pred, 18 IPF TLC: 42±13 %pred, 4 bronchiectasis FEV1: 28±4 %pred and 1 alveolitis fibrotisans TLC: 31 %pred) participated in a pre-and 14 took part in a post-transplant rehabilitation program (more than 2 months after lung transplantation (LTx), primary diagnoses: 9 COPD, 4 IPF). The rehabilitation program consisted of chest-wall stretching, controlled breathing techniques and personalized exercise of 20-30 minutes by cycling and treadmill 2-3 times per day for 4 weeks. Seven functional and quality of life markers, like lung function, chest wall expansion (CWE), 6-minute walking distance (6MWD), modified Medical Research Council Dyspnea Scale (mMRC), COPD Assessment Test (CAT), breath holding time (BHT) and hand grip strength (HGS) were measured at the onset and the end of the rehabilitation program. The safety profile of the rehabilitation program was followed-up. Results: Pre-transplant pulmonary rehabilitation resulted in significant improvement in CWE (3.24±1.49 vs. 4.48±1.62 cm), CAT IQR {19 [13-25] vs. 15 [11-21]}, 6MWD (315±118 vs. 375±114 m), P<0.05. FEV1, FVC, mMRC, BHT and HGS did not change significantly. Post-transplant rehabilitation resulted in significant improvement in CWE (3.7±2.1 vs. 6.2±1.8 cm), CAT IQR {17 [11-23] vs. 10 [6-14], BHT (22±14 vs. 35±16 s), FEV1 (73±8 vs. 86±9 %pred) and FVC (70±12 vs. 85±14 %pred), P<0.05. The 6MWD, mMRC and HGS did not change significantly. No cardiovascular or other side effects were detected during the rehabilitation program.Conclusions: Our results underline the importance of perioperative pulmonary rehabilitation in the complex treatment of lung transplant patients in Hungary, as well. There was a limitation because no control group was evaluated without rehabilitation.

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“…Systemic in ammation itself is associated with decreased serum HDL and increased TG levels in COPD [23], it has been shown that in ammatory cytokines disrupt lipid metabolism, there is an inverse correlation between serum HDL and IL-6 levels [24]. Patients with COPD are physically inactive, which further increases the risk of dyslipidemia, and they often use corticosteroids, which also increases the occurance of dyslipidemia and obesity [25].…”

Section: Discussionmentioning

confidence: 99%

Metabolic and Inflammatory Profile in Patients with COPD

Fekete

Szöllösi

Tarantini

et al. 2020

Preprint

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Background: In COPD, aside from obesity, decreased physical activity significantly increases the probability of developing metabolic syndrome, which can have a great impact on the natural course of COPD. Objective: The purpose of our study was to evaluate the prevalence of metabolic syndrome and whether it is related to age, sex, comorbidities, drug intake, degree of impairment of lung function, nutritional status, physical activity and quality of life. Methods: A cross-sectional study was performed on patients in Budapest at the Department of Pulmonary Rehabilitation of the National Koranyi Institute of Pulmonology between March 1, 2019 and March 1, 2020. The anthropometric and respiratory function tests and laboratory parameters of a random sample of 401 patients were known. Metabolic syndrome was determined according to IDF criteria and by definition CRP levels above 5.0 mg/L were considered elevated. Results: Metabolic syndrome occurred in 59.1% of COPD patients, male: 49.7% female: 67.6% (p <0.001). Patients with metabolic syndrome had worse FEV1%pred (43 (30-56) vs. 47 (36-61); p=0.028), lower 6MWD (250 (150-330) vs. 277 (162-360); p=0.235), lower quality of life, and significantly higher number of exacerbations (3 (1-6) vs.1 (0-3); p <0.001), than patients without metabolic syndrome. C-Reactive protein level was elevated in 55.1% of patients, higher in patients with metabolic syndrome, but the difference was not significant (7.0 (2-18) vs. 5.1 (1-17); p = 0.064). Conclusions: MetS can affect respiratory function, physical activity, quality of life and the number of exacerbations and is related to nutritional status and the level of systemic inflammation.

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Pulmonary Arterial Pressure Response During Exercise in COPD: A Correlation with C-Reactive Protein (hsCRP)

Cited by 18 publications

References 39 publications

A krónikus obstruktív tüdőbetegség metabolikus következményei

A krónikus obstruktív tüdőbetegség metabolikus következményei

The effectiveness of pulmonary rehabilitation in connection with lung transplantation in Hungary

Metabolic and Inflammatory Profile in Patients with COPD

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