The Prevalence of Metabolic Syndrome In Chronic Obstructive Pulmonary Disease: A Systematic Review

Abstract

Type 2 Diabetes Mellitus (T2DM) and cardiovascular diseases (CVD) are common in patients with chronic obstructive pulmonary disease (COPD). Prevention of these co-morbidities in COPD requires knowledge on their risk factors. Metabolic syndrome (MetS) predisposes to the development of T2DM and CVD but its prevalence in COPD remains unclear. The aim of this review was to assess the prevalence of MetS and its components in COPD patients compared to controls and to investigate the contribution of clinical characteristics to MetS prevalence. We systematically searched PubMed and EMBASE for original studies in COPD that have investigated the prevalence of MetS and its components. In total, 19 studies involving 4208 COPD patients were included. The pooled MetS prevalence was 34%. Compared to controls, the prevalence was higher in COPD (10 studies, 32% and 30%, p = 0.001). The three most prevalent components in both COPD and controls were arterial hypertension (56% and 51%), abdominal obesity (39% and 38%) and hyperglycemia (44% and 47%). Compared to COPD patients without MetS, those with MetS had higher body mass index (BMI) (29.9 and 24.6 kg/m 2 , p < 0.001), higher forced expiratory volume in 1 second (FEV 1 ) % predicted (54 and 51, p < 0.001) and were more frequently female (31% and 25%, p = 0.011). In conclusion, the prevalence of MetS in COPD patients is high and hypertension, abdominal obesity and hyperglycemia are the most prevalent components. Further studies are needed to evaluate the impact of lifestyle factors and medications on MetS in COPD.

Metabolic Disorder in Chronic Obstructive Pulmonary Disease (COPD) Patients: Towards a Personalized Approach Using Marine Drug Derivatives

“…MetD is also associated with a prothrombotic and a pro-inflammatory state [13]. A recent systematic review, that includes 19 studies involving 4208 COPD patients, evidences the presence of MetD in the 34% of population with high prevalence of arterial hypertension, abdominal obesity, and hyperglycemia [14]. In a group of elderly 877 patients (74 years median) admitted to San Raffaele Group Pulmonary Rehabilitation Units, 84% patients have 1–4 comorbidities and 10% >4 with an increasing trend of multimorbidity over recent years, mainly 58.6% (514 patients) suffer from arterial hypertension, 24.4% (214 patients) diabetes, 21.4% (188 patients) obesity and 7% (61 patients) dyslipidemia [15].…”

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

“…While increasing numbers of studies indicate that the systemic inflammatory pathway provides the general link between COPD and T2DM, the mechanisms by which the inflammatory component arises are unclear. Inflammatory cytokines can lead to T2DM by prolonging insulin resistance and changing energy production .…”

“…Type 2 diabetes mellitus (T2DM) and chronic obstructive pulmonary disease (COPD) are two common chronic diseases that occur frequently in the elderly, and the incidence of T2DM combined with COPD tends to increase year by year . The mechanistic associations between T2DM and COPD are complicated, multifactorial, and not completely understood, but they can influence the therapeutic method.…”

Cardiac Natriuretic Peptides, Hypertension and Cardiovascular Risk

“…Predictive value of elevated BNP levels on mortality has been tested also in several clinical scenarios different from CVD, such as chronic obstructive pulmonary disease and end stage renal disease [104]. These conditions are characterized by a low-grade chronic inflammation [105] and often coexist with MetS and CVD [106]. Given the beneficial role of NPs on energy expenditure and low-grade chronic inflammation, we think that lipid and glucose NPs-mediated metabolism may play a protective role also in these conditions.…”