Targeting Mechanisms Linking COPD to Type 2 Diabetes Mellitus

Cazzola, Mario; Rogliani, Paola; Calzetta, Luigino; Lauro, Davide; Page, Clive; Matera, Maria Gabriella

doi:10.1016/j.tips.2017.07.003

Cited by 52 publications

(63 citation statements)

References 72 publications

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“…The clinical presentation of elderly smokers with COPD and CHF is complicated by the frequent presence of several concomitant chronic diseases (comorbidities), including metabolic disorders [10].…”

Section: Introductionmentioning

confidence: 99%

Three-Year Hospitalization and Mortality in Elderly Smokers with Chronic Obstructive Pulmonary Disease or Chronic Heart Failure

et al. 2018

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Background: In elderly smokers, chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) usually present with dyspnoea. COPD and CHF are associated almost invariably with concomitant chronic diseases, which contribute to severity and prognosis. Objectives: We investigated similarities and differences in the clinical presentation, concomitant chronic diseases and risk factors for mortality and hospitalization at 3-year follow-up in elderly smokers/ex-smokers with a primary diagnosis of COPD or CHF recruited and followed in specialized centers. Methods: We examined 144 patients with COPD and 96 with CHF, ≥65 years, ≥20 pack/years, and measured COPD Assessment Test (CAT) score, modified Medical Research Council, NYHA, and Charlson Index, routine blood test, estimated glomerular filtration rate, HRCT scan, 6-min walk test. In addition, in each patient we actively searched for CHF, COPD, peripheral vascular disease, and metabolic syndrome. Results: COPD and CHF patients had mild to moderate disease, but the majority was symptomatic. Comorbidities were highly prevalent and often unrecognized in both groups. COPD and CHF patients had a similar risk of hospitalization and death at 3 years. Lower glomerular filtration rate, shorter 6MWT, and ascending aorta calcification score ≥2 were independent predictors of mortality in COPD, whereas previous 12 months hospitalizations, renal disease, and heart diameter were in CHF patients. Lower glomerular filtration rate value, higher CAT score, and lower FEV₁/FVC ratio were associated with hospitalization in COPD, while age, lower FEV₁% predicted, and peripheral vascular disease were in CHF. Conclusions: There are relevant similarities and differences between patients with COPD and CHF even when admitted to specialized outpatient centers, suggesting that these patients should be manage in multidisciplinary units.

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Section: Introductionmentioning

confidence: 99%

Three-Year Hospitalization and Mortality in Elderly Smokers with Chronic Obstructive Pulmonary Disease or Chronic Heart Failure

et al. 2018

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“…Indeed, there are potential mechanisms of interaction between COPD and the components of the metabolic syndrome, e.g., arterial Rutschmann [76] Choi [77] Erelel [80] Bahloul [81] Gunen [75] Shapira-Rootman [79] Tillie-Leblond [74] Akpinar [78] Ryan [72] Baum [71] Prevalense of PE (%) Figure 6. , and overweight/obesity.…”

Section: Metabolic Diseasesmentioning

confidence: 99%

“…, and overweight/obesity. All this suggest that the coexistence of COPD and metabolic syndrome or some of its components may increase the severity of its clinical manifestations and future risks 71,72 .…”

Section: Metabolic Diseasesmentioning

confidence: 99%

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Chronic Respiratory Abnormalities in the Multi-Morbid Frail Elderly

Beghè¹,

Clini²,

Fabbri³

2017

BRN

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Two-thirds of people aged ≥65 years have multi-morbidity. Multi-morbidity includes both physical and mental health conditions, as anxiety and depression, that almost invariably affect patients with multiple symptomatic chronic diseases. Management of a patient with any of the chronic diseases that are part of multi-morbidity is not just the management of that single index disease, but must include the active search and proper treatment of concomitant chronic diseases. The presence of concomitant chronic diseases should not alter the management of the index disease (e.g., chronic obstructive pulmonary disease [COPD]), and concomitant chronic diseases should be treated according to single diseases guidelines regardless of the presence of the index disease, obviously with careful consideration that this choice implies complex management, polypharmacy and potential adverse effects. Preliminary management programs suggest that a holistic integrated approach might improve quality of life and reduce hospital admissions and death in these multimorbid patients. (BRN Rev. 2017;3:247-66)

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“…Recently, it has been reported that T2DM and COPD are not merely metabolic disorder or obstructive lung disease, but are also related to inflammatory dysfunction . While the systemic inflammatory pathway provides the universal relation between COPD and T2DM, the mechanisms by which the systemic component arises are unclear.…”

Section: Introductionmentioning

confidence: 99%

Clinical significance of high‐mobility group box‐1 (HMGB1) in subjects with type 2 diabetes mellitus (T2DM) combined with chronic obstructive pulmonary disease (COPD)

Huang

Zeng

Tian

et al. 2019

Clinical Laboratory Analysis

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Background Simple method to predict type 2 diabetes mellitus (T2DM) combined with chronic obstructive pulmonary disease (COPD) is in great need clinically. This study aims to assess the clinical significance of high‐mobility group box‐1 (HMGB1) in predicting T2DM combined with COPD in Chinese patients with T2DM or COPD. Methods Serum concentrations of glycated hemoglobin (HbA1C), fasting plasma glucose (FPG), fasting insulin (FINS), total cholesterol (TC), triglyceride (TG), low‐density lipoprotein cholesterol (LDL‐c), high‐density lipoprotein cholesterol (HDL‐c), C‐reactive protein (CRP), fibrinogen (FIB), HMGB1, white blood cell count (WBC), neutrophil% (NEU%), and lung function text such as forced expiratory volume 1/forced vital capacity (FEV1/FVC) and forced expiratory volume 1% predicted value (FEV1%pred) were measured in 126 T2DM patients, 118 COPD patients, 112 T2DM combined with COPD patients, and 120 healthy controls. Logistic regression was used to estimate the risk factors for T2DM combined with COPD. Results High‐mobility group box‐1 elevated in patients with T2DM combined with COPD, significantly higher than other subjects (P < 0.05), and differences in HMGB1 also existed between patients with T2DM or COPD and healthy individuals (P < 0.01). HMGB1 was positively correlated with HOMA‐IR, FBG, and HbA1c (P < 0.01) and negatively correlated with FEV1/FVC and FEV1%pred (P < 0.01). Logistic regression showed that HMGB1 was identified to be independent risk factor for T2DM combined with COPD. Conclusion High‐mobility group box‐1 was independent risk factor for T2DM combined with COPD and can be served to predict the occurrence of T2DM combined with COPD.

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Targeting Mechanisms Linking COPD to Type 2 Diabetes Mellitus

Cited by 52 publications

References 72 publications

Three-Year Hospitalization and Mortality in Elderly Smokers with Chronic Obstructive Pulmonary Disease or Chronic Heart Failure

Three-Year Hospitalization and Mortality in Elderly Smokers with Chronic Obstructive Pulmonary Disease or Chronic Heart Failure

Chronic Respiratory Abnormalities in the Multi-Morbid Frail Elderly

Clinical significance of high‐mobility group box‐1 (HMGB1) in subjects with type 2 diabetes mellitus (T2DM) combined with chronic obstructive pulmonary disease (COPD)

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