Medicina Pulmonar e Respiratória

Study of Metabolic Syndrome in Chronic Obstructive Pulmonary Disease and its Clinical Implications

Abstract

Panda G, Patro M, Seth HK, Pattanaik M, Meher BK and Sahoo J

Background: Chronic Obstructive Pulmonary Disease (COPD) is not only a disease of lungs but is also associated with significant extra-pulmonary effects. Metabolic syndrome (MS) and associated cardiovascular morbidity and mortality are more frequent in COPD.
Objective: To study the prevalence of MS in hospitalised COPD patients. To compare their clinical characteristics with presence of MS. To correlate the presence of MS with GOLD spirometric severity and ABCD groups.
Methods: With a cross-sectional design, 100 hospitalised COPD patients were studied. They were asked about history, subjected to clinical examination and investigations to screen for MS and comorbidities. MS was identified using modified NCEP-ATPIII criteria and COPD was diagnosed based on GOLD guidelines 2017. They were classified based on spirometric grading and combined ABCD assessment. Being hospitalised patients, all subjects were either in group B or group D.
Results: MS was found in 40% of COPD patients. Patients with coexisting MS had more number of exacerbations (mean 2.50 vs. 2.03), prior history of hospitalisation (37.5% vs. 30%), longer duration of hospitalisation (7.25 vs. 4.73 days) and higher prevalence of comorbidities like diabetes and hypertension, as compared to those with COPD alone. The prevalence of MS decreased with increasing spirometric severity, with highest prevalence in mild obstruction (66.7%). Prevalence of MS was higher in group D patients as compared to group B (48.4% vs. 25%).
Conclusion: The presence of MS is frequent in hospitalised COPD patients and is associated with adverse clinical parameters. It is more common in earlier spirometric grades and Group D patients. Hence, this population should be considered for screening for MS.