Prevalence of Metabolic Syndrome in COPD Patients and Its Consequences

30-07-2019
Chronic obstructive pulmonary disease (COPD) is characterized by persistent limitation of airflow that is usually progressive. In addition, exacerbations and co-existent morbidities contribute to the overall severity of the individual patient. Cardiovascular comorbidities are common in COPD and are associated with an increased risk of death. To date, the underlying mechanisms can only be partially understood. In addition to smoking, other factors may play a role, including old age, medication, systemic inflammation and metabolic disorders.

Metabolic syndrome is a common metabolic disorder that is defined as a complex of interrelated cardiovascular risk factors. The syndrome, depending on age, has been associated with various other health problems and an increased risk of death. In addition, metabolic syndrome has clinically relevant negative effects on the exercise capacity of individuals, as well as on the state of health. This while protective effects are described on bone mineral density (BMD).
To date, the prevalence of metabolic syndrome in COPD patients compared to healthy subjects has hardly been studied. Compared with COPD patients without metabolic syndrome, COPD patients with metabolic syndrome are physically less active and have elevated levels of systemic inflammation. It is still largely unknown whether and to what extent other clinical outcomes, such as spirometry, functional training performance, mood and health status, and the prevalence of cardiovascular comorbidity may differ between COPD patients with and without metabolic syndrome. It is therefore of great importance to gain more insight into the impact of metabolic syndrome on the clinical outcomes of COPD patients in order to better characterize this subgroup of COPD patients in the future.
The prevalence of metabolic syndrome and clinical and functional characteristics in patients with COPD and healthy subjects were evaluated. 228 COPD patients and 156 healthy subjects were included. Metabolic syndrome was defined using criteria from the IDF. Spirometry, body composition, functional training performance and mood and health status were assessed in all patients. Groups were stratified for BMI and gender.
Metabolic syndrome was present in 57% of COPD patients and 40% of healthy subjects. After stratification for BMI, the presence of metabolic syndrome was higher in patients with BMI ≥ 25 kg / m2 than in healthy peers. Patients with metabolic syndrome and a BMI <25 kg / m2 had a higher BMI, fat-free mass index and bone mineral density and a lower 6 MWD than the BMI-matched patients without metabolic syndrome. Spirometry, maximum ergometry, mood and health status and blood gasses corresponded between the groups. In COPD patients with metabolic syndrome, self-reported comorbidities and medication use were higher than those without.
Metabolic syndrome is more common in overweight or obese patients with COPD than in healthy BMI patients. Metabolic syndrome did not have an additional effect on the functional outcomes of patients, but did influence the prevalence of comorbidities.

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