The impact of comorbidities on mortality among men and women with COPD: report from the OLIN COPD study

Abstract

Background: Comorbidities probably contribute to the increased mortality observed among subjects with chronic obstructive pulmonary disease (COPD), but sex differences in the prognostic impact of comorbidities have rarely been evaluated in population-based studies. The aim of this study was to evaluate the impact of common comorbidities, cardiovascular disease (CVD), diabetes mellitus (DM), and anxiety/depression (A/D), on mortality among men and women with and without airway obstruction in a population-based study. Methods: All subjects with airway obstruction [forced expiratory volume in 1 second (FEV1)/(forced) vital capacity ((F)VC) <0.70, n = 993] were, together with age- and sex-matched referents, identified after examinations of population-based cohorts in 2002–2004. Spirometric groups: normal lung function (NLF) and COPD (post-bronchodilator FEV1/(F)VC <0.70) and additionally, LLN-COPD (FEV1/(F)VC <lower limit of normal). Mortality data was collected until December 2015. Results: In COPD, the prevalence of CVD and DM was higher in men, whereas the prevalence of A/D was higher in women. The cumulative mortality was significantly higher in COPD than NLF, and higher in men than women in both groups. Among women with COPD, CVD and A/D but not DM increased the risk of death independent of age, body mass index, smoking habits, and disease severity, whereas among men DM and A/D but not CVD increased the risk for death. When the LLN criterion was applied, the pattern was similar. Conclusion: There were sex-dependent differences regarding the impact of comorbidities on prognosis in COPD. Even though the prevalence of CVD was higher in men, the impact of CVD on mortality was higher in women, and despite higher prevalence of A/D in women, the impact on mortality was similar in both sexes. The reviews of this paper are available via the supplemental material section.

Multimorbidity clusters in patients with chronic obstructive airway diseases in the EpiChron Cohort

“…Depression frequently co-exists in patients with respiratory disorders such as asthma and COPD 22 , 23 ; in our study, it was common comorbidity in clusters with cardiometabolic diseases. In women, depression was amongst the main conditions in two multimorbidity clusters, the dyslipidemic-depressive, and the depressive-degenerative clusters.…”

“…In the last one, we found that depression was associated with hypertension, congestive heart failure, and degenerative diseases, with significantly high mortality risk. A recent study in COPD patients reported that cardiovascular disease is more prevalent in men, but its impact on mortality is higher in women, and that although depression is more common in women, its impact on mortality is similar in both genders 23 .…”

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

“…In the study of Sawalha et al, the most common comorbidities in men were cardiovascular disease and diabetes mellitus, while in women anxiety and depression. Hypertension is a disorder of lipid metabolism and obesity 35 . This finding also confirms the results of the García et al, showing that common comorbidities in 3183 people with COPD in Spain included diabetes, high blood pressure, lipid metabolism disorders, and obesity 36 .…”

Chronic hypoxaemia and gender status modulate adiponectin pathway in severe COPD patients: new endotypic presentation?

“…The prevalence of co-morbidity also varied with gender in COPD patients and men were described to be more susceptible to CV and diabetes mellitus (10).…”