The Metabolic Syndrome in Patients With Chronic Bronchitis and COPD

Watz, Henrik; Waschki, Benjamin; Kirsten, Anne; Müller, Kai-Christian; Kretschmar, Gunther; Meyer, Thorsten; Holz, Olaf; Magnussen, H

doi:10.1378/chest.09-0393

Cited by 217 publications

(123 citation statements)

References 40 publications

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“…However, literature linking metabolic syndrome as a whole with COPD is scarce. It has also been proven that the prevalence of metabolic syndrome is higher in patients with COPD than in the general population [6][7][8][9] In a study conducted by Watz H et-al on chronic bronchitis and COPD patients, it was reported that half of the patients included had metabolic syndrome irrespective of disease stage and severity. Besides, an association with markers of systemic inflammation, particularly the pro-inflammatory cytokines namely; Tumor necrosis factor-α (TNF-α), Interleukin (IL-6) Creactive protein (CRP) and fibrinogen was demonstrated.…”

Section: Discussionmentioning

confidence: 99%

“…18 A study conducted by Watz H, et al concluded that there was a high prevalence of hypertension in all stages of COPD; being as high as 70%. 6 Study conducted by Karine M et al states 59% of COPD cases had raised blood pressure. A health survey conducted several years.…”

Section: Individual Diseases and Msmentioning

confidence: 99%

“…However, it was observed that our study has demonstrated a higher prevalence of DM in contrast with prevalence reported in other studies. 6,9,19 The prevalence of diabetes in COPD is approximately about 3-12%. A study by Engstrom et al described that reduced lung function is an important risk factor for the development of diabetes in COPD.…”

Section: Individual Diseases and Msmentioning

confidence: 99%

“…[6][7][8][9] In a study conducted by, Watz H et al on COPD patients states that metabolic syndrome was found in almost half of the patients having COPD irrespective of disease stage and was associated with markers of systemic inflammation, particularly the pro inflammatory cytokines Tumor necrosis factor-α (TNF-α) and interleukin (IL-6) C-reactive protein (CRP) and fibrinogen. 6 An epidemiological study conducted in China in 2010 shows strong association between metabolic syndrome and COPD. The researchers also concluded that metabolic syndrome was identified in approximately 20% of patients with COPD, and this correlated most closely with central obesity.…”

Section: Introductionmentioning

confidence: 99%

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Metabolic syndrome in chronic obstructive pulmonary disease

et al. 2018

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Background: COPD (Chronic obstructive pulmonary disease) is considered as a systemic disease due to associated systemic inflammation which can manifest as metabolic syndrome or its component illnesses. This study was undertaken to determine the proportion of metabolic syndrome in patients with COPD.Methods: 51 patients with COPD were compared with equal number of age and gender matched controls. GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteria were used for diagnosing COPD. Metabolic Syndrome (MS) was diagnosed based on modified NCEP:ATP III criteria (National cholesterol education Program Adult Treatment Panel III). Subjects were evaluated for hypertension, WC, FBS, and serum triglycerides and serum HDL (High-density lipoprotein) to diagnose MS.Results: Metabolic syndrome was diagnosed in 16 (31.4%) patients with COPD and in 8 (15.7%) controls. The proportion of individual parameters of MS in cases and controls was as follows: DM in 19 (37.3%) cases and 13 (25.5%) controls, hypertension in 21(41.2%) cases and 9 (17.6%) controls, low serum HDL in 31 (60.7%) cases and 22 (43.1%) controls increased WC in 14 (27.5%) cases and 7 (13.7%) controls and elevated serum TG in 12 (23.5%) cases and an equal number of controls.Conclusions: Metabolic syndrome and its parameters are more prevalent in COPD patients. Early detection and treatment of MS in COPD patients can prevent development of complications due to the combined effects of both diseases.

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Section: Discussionmentioning

confidence: 99%

Section: Individual Diseases and Msmentioning

confidence: 99%

Section: Individual Diseases and Msmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Metabolic syndrome in chronic obstructive pulmonary disease

et al. 2018

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“…In this respect, the frequent coexistence of COPD and metabolic syndrome [6] may increase the systemic burden of pro-inflammatory cytokines due to their overproduction by the increased visceral adipose tissue mass.…”

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confidence: 99%

COPD and osteoporosis: something more than a comorbidity

Tantucci

2012

Endocrine

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Chronic obstructive lung disease (COPD) is a progressive functional disorder of the respiratory system with high prevalence in the older population and is presently the fourth cause of mortality and supposed to be the third in the 2020 in the world [1]. Large part of COPD morbidity and mortality is due to extra-pulmonary effects rather than pulmonary consequences of this disorder, mainly when the airway obstruction is mild or moderate [2]. Among the extra-pulmonary effects, osteopenia and osteoporosis, as a consequence of a loss of bone mineral density (BMD), have been widely recognized as a major comorbidity in COPD patients [3].While age, female sex and smoking are common pathogenetic factors, other factors such as reduced daily physical activity, malnutrition, low body mass index, hypogonadism, vitamin D deficiency, chronic renal insufficiency, chronic hypoxemia, and drugs (especially corticosteroids), due to COPD occurrence and progression, have been invoked to explain such a frequent association [4]. However, the presence of a low BMD even in COPD patients with milder airflow obstruction in whom the above mentioned, associated risk factors are less prevalent, may suggest another link between these two conditions.In this article of the Journal, Liang and Feng add evidence to the belief that low-grade systemic inflammation, frequently observed in clinically stable COPD patients, could be the main underlying mechanism able to explain this relationship [5]. In this respect, the frequent coexistence of COPD and metabolic syndrome [6] may increase the systemic burden of pro-inflammatory cytokines due to their overproduction by the increased visceral adipose tissue mass.More than 60 % of their COPD patients had osteopenia (34 %) and osteoporosis (29 %). Using the plasma level of CRP, IL-6 and TNF-a as surrogate marker of systemic inflammation, the authors found significantly higher levels of these cytokines in those COPD patients with abnormal BMD. Moreover, the risk of a low BMD was significantly increased by a factor 3 in the presence of elevated degree of systemic inflammation and only the levels of TNF-a and IL-6 were retained as independent predictors at a multivariate logistic analysis for a low BMD [5].Two relevant facts clearly emerge from this study: again the high prevalence of osteopenia and osteoporosis, when properly assessed by dual-energy X-ray absorptiometry, in COPD patients showing moderate-to-severe airway obstruction and the strong relationship between the presence of COPD-related systemic inflammation and low BMD, even after adjustment for age, sex, use of inhaled corticosteroids (ICS), and severity of airflow obstruction.Although the influence of other potential risk factors, particularly the daily physical activity that can be markedly reduced also in the mild-to-moderate COPD patients, was not taken into account, it is important to be aware that the severity of airway obstruction and the use of ICS are less strongly associated with the loss of BMD, than the increased plasma level of pro-inf...

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Hypoalbuminemia: Pathogenesis and Clinical Significance

Soeters

Wolfe

Shenkin

2018

J Parenter Enteral Nutr

625

554

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Hypoalbuminemia is associated with inflammation. Despite being addressed repeatedly in the literature, there is still confusion regarding its pathogenesis and clinical significance. Inflammation increases capillary permeability and escape of serum albumin, leading to expansion of interstitial space and increasing the distribution volume of albumin. The half‐life of albumin has been shown to shorten, decreasing total albumin mass. These 2 factors lead to hypoalbuminemia despite increased fractional synthesis rates in plasma. Hypoalbuminemia, therefore, results from and reflects the inflammatory state, which interferes with adequate responses to events like surgery or chemotherapy, and is associated with poor quality of life and reduced longevity. Increasing or decreasing serum albumin levels are adequate indicators, respectively, of improvement or deterioration of the clinical state. In the interstitium, albumin acts as the main extracellular scavenger, antioxidative agent, and as supplier of amino acids for cell and matrix synthesis. Albumin infusion has not been shown to diminish fluid requirements, infection rates, and mortality in the intensive care unit, which may imply that there is no body deficit or that the quality of albumin “from the shelf” is unsuitable to play scavenging and antioxidative roles. Management of hypoalbuminaemia should be based on correcting the causes of ongoing inflammation rather than infusion of albumin. After the age of 30 years, muscle mass and function slowly decrease, but this loss is accelerated by comorbidity and associated with decreasing serum albumin levels. Nutrition support cannot fully prevent, but slows down, this chain of events, especially when combined with physical exercise.

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The Metabolic Syndrome in Patients With Chronic Bronchitis and COPD

Cited by 217 publications

References 40 publications

Metabolic syndrome in chronic obstructive pulmonary disease

Metabolic syndrome in chronic obstructive pulmonary disease

COPD and osteoporosis: something more than a comorbidity

Hypoalbuminemia: Pathogenesis and Clinical Significance

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