DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20195933

A study to investigate the prevalence of metabolic syndrome in Chronic Obstructive Pulmonary Disease patients from North India

Anand Kumar, Sachin Gupta, Sudhir Chaudhri, Sanjay Kumar Verma, Avdhesh Kumar, S. K. Sinha, Vishal Gupta, Surya Kant

Abstract


Background: Worldwide, Chronic obstructive pulmonary disease (COPD) is the one of the leading cause of chronic morbidity and mortality. COPD is one of the diseases in which smoking is the common and important risk factor when it is associated with Metabolic syndrome (MetS). The individual components of MetS, i.e., obesity, dyslipidemia, fasting hyperglycaemia, and hypertension were independently associated with impairment of lung function too. The objective of this study is to find out the prevalence of metabolic syndrome among COPD patients.

Methods: This was a cross-sectional study conducted in department of Respiratory Diseases and a total of 70 COPD patients were included in the study, which were enrolled for treatment from July 2016 to July 2017. The severity level in patients with COPD were determined according to GOLD (Global Initiative for Chronic Obstructive Lung Disease), 2015 guideline. International Diabetes Federation (IDF) guideline; (2005) was used in diagnosis of metabolic syndrome.

Results: Seventy patients with COPD were enrolled during the study period. There were 45 males (64.2%) and 25(35.7%) females. Mean age of male patients was 58.67±9.87 years, while mean age of female patients was 57.23±10.4 years (35-87 years). Mean BMI of male was 24.33±6.64 kg/m2, while in case of female it was 30.07±6.95 kg/m2 and overall mean BMI of study population was 26.22±7.22 kg/m2. The mean   waist circumference of male was 86.91±13.31 cm while in female it was 87.18±14.51 cm. The Overall prevalence of metabolic syndrome was 31.34% and most common in GOLD stage-3 (47.06%), followed by stage-2 (40%), followed by stage-4 (25.71%) and 7.4 % in GOLD stage -1.

Conclusions: The presence of metabolic syndrome is common in patients with COPD and, all COPD patients should be considered for screening for it.


Keywords


Chronic obstructive pulmonary disease, Metabolic syndrome, Obesity, Smoking

Full Text:

PDF

References


Global Initiative for Chronic Obstructive Lung Disease (GOLD). GOLD 2015 global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease, 2015 report.

Available at: http://goldcopd.org/gold-2015-global-strategy-diagnosis-management-preve. Accessed 17 November 2015.

Soriano JB, Abajobir AA, Abate KH, Abera SF, Agrawal A, Ahmed MB, et al. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Res Med. 2017 Sep 1;5(9):691-706.

WHO: burden of chronic obstructive pulmonary disease. Available at: http://www.who.int/respiratory/copd/burden/en/index.html. Accessed 29 August 2011.

Dandona L, Dandona R, Kumar GA, Shukla DK, Paul VK, Balakrishnan K, et al. Nations within a nation: variations in epidemiological transition across the states of India, 1990-2016 in the Global Burden of Disease Study. Lancet. 2017 Dec 2;390(10111):2437-60.

Jindal SK. Emergence of chronic obstructive pulmonary disease as an epidemic in India. Ind J Med Res. 2006 Dec 1;124(6):619-30.

Lopez AD, Shibuya K, Rao C, Mathers CD, Hansell AL, Held LS, et al. Chronic obstructive pulmonary disease: current burden and future projections. Euro Res J. 2006 Feb 1;27(2):397-412.

Jindal SK, Aggarwal AN, Gupta D, Agarwal R, Kumar R, Kaur T, et al. Indian study on epidemiology of asthma, respiratory symptoms and chronic bronchitis in adults (INSEARCH). Inter J Tuberculosis Lung Dis. 2012 Sep 1;16(9):1270-7.

Burney P, Kato B, Janson C, Mannino D, Studnicka M, Tan W, et al. Chronic obstructive pulmonary disease mortality and prevalence: the associations with smoking and poverty: a BOLD analysis-authors’ reply. Thorax. 2014 Sep 1;69(9):869-70.

Fabbri LM, Rabe KF. From COPD to chronic systemic inflammatory syndrome?. Lancet. 2007 Sep 1;370(9589):797-9.

Agusti A, Soriano JB. COPD as a systemic disease. COPD: J Chronic Obstr Pulmonary Dis. 2008 Jan 1;5(2):133-8.

Steuten LM, Creutzberg EC, Vrijhoef HJ, Wouters EF. COPD as a multicomponent disease: inventory of dyspnoea, underweight, obesity and fat free mass depletion in primary care. Pri Care Resp J. 2006 Apr 1;15(2):84-91.

Isomaa BO, Almgren P, Tuomi T, Forsén B, Lahti K, Nissen M, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care. 2001 Apr 1;24(4):683-9.

Haffner SM, Valdez RA, Hazuda HP, Mitchell BD, Morales PA, Stern MP. Prospective analysis of the insulin-resistance syndrome (syndrome X). Diabetes. 1992 Jun 1;41(6):715-22.

Sutherland JP, McKinley B, Eckel RH. The metabolic syndrome and inflammation. Metab Syndr Relat Disord. 2004;2:82-204.

Marquis K, Maltais F, Duguay V, Bezeau AM, LeBlanc P, Jobin J, et al. Metabolic syndrome in patients with chronic obstructive pulmonary disease. J Cardio pulm Rehabil. 2005;25:226-32.

Park SK, Larson JL. The relationship between physical activity and metabolic syndrome in people with chronic obstructive pulmonary disease. J Cardiovas Nursing. 2014 Nov;29(6):499-507.

Park SK, Larson JL. Metabolic syndrome and associated factors in people with chronic obstructive pulmonary disease. West J Nursing Res. 2014 May;36(5):620-42.

Poulain M, Doucet M, Drapeau V, Fournier G, Tremblay A, Poirier P, et al. Metabolic and inflammatory profile in obese patients with chronic obstructive pulmonary disease. Chronic Resp Dis. 2008 Feb;5(1):35-41.

Tanni SE, Zamuner AT, Coelho LS, Vale SA, Godoy I, Paiva SA. Are metabolic syndrome and its components associated with 5-year mortality in chronic obstructive pupmonary disease patients?. Metab Syndrome Related Disord. 2015 Feb 1;13(1):52-4.

Diez-Manglano J, Barquero-Romero J, Almagro P, Cabrera FJ, Garcia FL, Montero L, et al. COPD patients with and without metabolic syndrome: clinical and functional differences. Int Emer Med. 2014 Jun 1;9(4):419-25.

Minas M, Kostikas K, Papaioannou AI, Mystridou P, Karetsi E, Georgoulias P, et al. The association of metabolic syndrome with adipose tissue hormones and insulin resistance in patients with COPD without co-morbidities. COPD: J Chronic Obstr Pulmonary Dis. 2011 Dec 9;8(6):414-20.

Breyer MK, Spruit MA, Hanson CK, Franssen FM, Vanfleteren LE, Groenen MT, et al. Prevalence of metabolic syndrome in COPD patients and its consequences. PloS One. 2014 Jun 20;9(6):e98013.

Watz H, Waschki B, Kirsten A, Müller KC, Kretschmar G, Meyer T, et al. The metabolic syndrome in patients with chronic bronchitis and COPD: frequency and associated consequences for systemic inflammation and physical inactivity. Chest. 2009 Oct 1;136(4):1039-46.

Fumagalli G, Fabiani F, Forte S, Napolitano M, Marinelli P, Palange P, et al. INDACO project: a pilot study on incidence of comorbidities in COPD patients referred to pneumology units. Multidisciplinary Resp Med. 2013 Dec;8(1):28.

Skyba P, Ukropec J, Pobeha P, Ukropcova B, Joppa P, Kurdiova T, et al. Metabolic phenotype and adipose tissue inflammation in patients with chronic obstructive pulmonary disease. Mediators Inflamm. 2010;2010.

Akpinar EE, Akpinar S, Ertek S, Sayin E, Gulhan M. Systemic inflammation and metabolic syndrome in stable COPD patients. Tuberk Toraks. 2012;60(3):230-7.

Küpeli E, Ulubay G, Ulasli SS, Sahin T, Erayman Z, Gürsoy A. Metabolic syndrome is associated with increased risk of acute exacerbation of COPD: a preliminary study. Endocrine. 2010 Aug 1;38(1):76-82.

Alpaydin AO, Arslan IK, Serter S, Coskun AS, Celik P, Taneli F, et al. Metabolic syndrome and carotid intima-media thickness in chronic obstructive pulmonary disease. Multidisciplinary Resp Med. 2013 Dec;8(1):61.

Hosny H, Abdel-Hafiz H, Moussa H, Soliman A. Metabolic syndrome and systemic inflammation in patients with chronic obstructive pulmonary disease. Egypt J Chest Dis Tuberc. 2013;62(1):85-9.

Park BH, Park MS, Chang J, Kim SK, Kang YA, Jung JY, Kim YS, Kim C. Chronic obstructive pulmonary disease and metabolic syndrome: a nationwide survey in Korea. Inter J Tubercu Lung Dis. 2012 May 1;16(5):694-700.

Lam KH, Jordan RE, Jiang CQ, Thomas GN, Miller MR, Zhang WS, et al. Airflow obstruction and metabolic syndrome: the Guangzhou Biobank Cohort Study. Euro Resp J. 2010 Feb 1;35(2):317-23.

Funakoshi Y, Omori H, Mihara S, Marubayashi T, Katoh T. Association between airflow obstruction and the metabolic syndrome or its components in Japanese men. Int Med. 2010;49(19):2093-9.

Chung JH, Hwang HJ, Han CH, Son BS, Kim DH, Park MS. Association between sarcopenia and metabolic syndrome in chronic obstructive pulmonary disease: the Korea National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2011. COPD: J Chronic Obstr Pulmonary Dis. 2015 Jan 2;12(1):82-9.

Dave L, Garde S, Ansari OA, Shrivastava N, Sharma VK. A study of association between metabolic syndrome and COPD. J Evol Med Dent Sci. 2014;3:6183‑8.

Shah S. Frequency of metabolic syndrome and its relationship with systemic inflammation in patients of chronic obstructive pulmonary disease (COPD) in ethnic Kashmiri population of India. Chest. 2014 Mar 1;145(3):400A.

Chindhi S, Thakur S, Sarkar M, Negi PC, Mantur VS. Metabolic Syndrome in COPD; A Case Control Study from Himachal Pradesh. Inter J Physiol. 2016 Jan;4(1):15-20.

Zimmet P, Magliano D, Matsuzawa Y, Alberti G, Shaw J. The metabolic syndrome: a global public health problem and a new definition. J atheroscler thrombosis. 2005;12(6):295-300.

Bulcun E, Ekici A, Ekici M. Metabolic syndrome and chronic diseases in patients with chronic obstructive pulmonary disease. Izmir Gogus Hospital J.2015; 29:1-10.

Mekov E, Slavova Y, Tsakova A, Genova M, Kostadinov D, Minche D, et al. Metabolic syndrome in hospitalized patients with chronic obstructive pulmonary disease. Peer Journal. 2015;3:e1068.

Helvaci MR, Aydin LY, Aydin Y. Chronic obstructive pulmonary disease may be one of the terminal end points of metabolic syndrome. Pak J Med Sci 2012; 28(3): 376-379.

Yasar Z, Buyuksirin M, Ucsular FD, Kargi A, Erdem F, Talay F, et al. Is an elevated neutrophil-to-lymphocyte ratio a predictor of metabolic syndrome in patients with chronic obstructive pulmonary disease. Eur Rev Med Pharmacol Sci. 2015 Mar 1;19(6):956-62.

Ameen NM, Deen RSE, Mageed NI, Wahab HA.. The metabolic syndrome in patients with chronic obstructive pulmonary disease. Egypt J Chest Dis Tuberculosis 2016;65:593-6.