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KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞINDA METABOLİK SENDROM VE KRONİK HASTALIKLAR

Yıl 2015, Cilt: 29 Sayı: 2, 75 - 84, 01.10.2015

Öz

Amaç: Kronik obstrüktif akciğer hastalığı (KOAH), metabolik sendrom (MS) ve komorbidite arasındaki ilişki üzerine yapılan önceki çalışmalarda bulunan sonuçlar tartışmalıdır. Bu nedenle biz bu çalışmada, KOAH'lı hastalarda eşlik eden metabolik sendrom ve komorbiditeleri ayrı ayrı olacak şekilde inceledik. Yöntem: Bu çalışma periyodu sırasında, 66 KOAH ve kontrol grubu olarak da 40 kişi dahil edildi. Solunum fonksiyon testleri (SFT) flow sensitif spirometri ile ATS kriterlerine göre yapıldı. BODE indeksleri hesaplandı. Kronik hastalıklar şiddet indeksi Modifiye kümülatif hastalıklar değerlendirme ölçeği (MKHDÖ) kullanılarak değerlendirildi. MS, National Cholesterol Education Program (NCEP)'a göre tanımlandı. Total metabolik bozukluk skoru da ayrıca hesaplandı. Bulgular: MKHDÖ skoru KOAH'lı hastalarda kontrol grubundan anlamlı olarak yüksekti fakat total metabolik skor KOAH ve kontrol grubu arasında farklı değildi. MS KOAH'lı hastalarda 18 kişide (%27.3), kontrol grubunda 8 kişide (%20) görüldü. MS görülme oranı evre II KOAH'lı hastalarda evre IV KOAH'lı hastalardan daha yüksekti (p:0.04). Lineer regresyon analizinde, MKHDÖ skoru BODE indeksi ile pozitif ilişki gösterirken, FEV1%, FVC%, FEV1/FVC% ile anlamlı negatif ilişki gösterdi. Ancak, MKHDÖ PO2 ile anlamlı ilişki göstermedi. Sonuç: Komorbiditeler ve MS KOAH'ın farklı evrelerinde görülür. Bu nedenle eşlik eden bu hastalıklar birbirinden ayrı ayrı olarak incelenmelidir.

Kaynakça

  • 1. Barnes PJ, Celli BR. Systemic manifestations and comorbidities of COPD. Eur Respir J 2009;33:1165-85.
  • 2. Sidney S, Sorel M, Quesenberry CP Jr, DeLuise C, Lanes S, Eisner MD. COPD and incident cardiovascular disease hospitalizations and mortality:Kaiser Permanente medical care program. Chest 2005;128:2068-75.
  • 3. Chatila WM, Thomashow BM, Minai OA, Criner GJ, Make BJ. Comorbidities in chronic obstructive pulmonary disease. Proc Am Thorac Soc 2008;5:549-55.
  • 4. Soriano JB, Visick GT, Muellerova H, Payvandi N, Hansell AL. Patterns of comorbidities in newly diagnosed COPD and asthma in primary care. Chest 2005;128:2099-107.
  • 5. Valdes AM, Andrew T, Gardner JP, Kimura M, Oelsner E, Cherkas LF, et al. Obesity, cigarette smoking, and telomere length in women. Lancet 2005;366:662-4.
  • 6. Luppi F, Franco F, Beghé B, Fabbri LM. Treatment of Chronic Obstructive Pulmonary Disease and Its ComorbiditiesProc Am Thorac Soc 2008;5:848-56.
  • 7. Parameswaran K, Todd DC, Soth M. Altered respiratory physiology in obesity. Can Respir J 2006; 13:203-10.
  • 8. Cecere LM, Littman AJ, Slatore CG, Udris EM, Bryson CL, Boyko EJ, et al. Obesity and COPD:associated symptoms, health-related quality of life, and medication use. COPD 2011; 8:275-84.
  • 9. Dandona P, Aljada A, Chaudhuri A, Mohanty P, Garg R. Metabolic syndrome:a comprehensive based on interactions between obesity, diabetes, and inflammation. Circulation 2005; 111:1448-54.
  • 10. Spurzem JR, Rennard Sl. Pathogenesis of COPD. Semin Respir Crit Care Med 2005; 26:142-53.
  • 11. Donaldson GC, Seemungal TA, Patel IS, Bhowmik A, Wilkinson TM, Hurst JR, et al.Airway and systemic inflammation and decline in lung function in patients with COPD. Chest 2005; 128:1995-2004.
  • 12. Čekerevac I, Lazić Z.Obesity and chronic obstructive pulmonary disease. Srp Arh Celok Lek 2011;139:322-7.
  • 13. King DA, Cordova F, Scharf SM. Nutritional Aspects of Chronic Obstructive Pulmonary Disease. Proc Am Thorac Soc 2008;5:519-23.
  • 14. Global Strategy of Diagnosis, Management and Prevention of COPD. 2006. http://www.goldcopd. org. Date last updated:December 2009.
  • 15. Standardization of spirometry. Statement of the American Thoracic Society. Am Rev Respir Dis 1987;136:1285-98.
  • 16. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute;National High Blood Pressure Education Program Coordinating Committee. Hypertension. 2003;42:1206-52.
  • 17. American Thoracic Society. ATS Statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002;166:111-7.
  • 18. Bestall JC, Paul EA, Garrod R, Garnham R, Jones PW, Wedzicha JA. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax 1999;54:581-6.
  • 19. Celli BR, Cote CG, Marin JM, Casanova C, Montes de Oca M, Mendez RA, et al. The bodymass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med 2004; 350:1005-12.
  • 20. Miller MD, Paradis CF, Houck PR, Mazumdar S, Stack JA, Rifai AH, et al. Rating chronic medical illness burden in geropsychiatric practice and research:application of the Cumulative Illness Rating Scale. Psychiatry Res 1992;41:237-48.
  • 21. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001; 285:2486-97.
  • 22. Broekhuizen R, Wouters EF, Creutzberg EC, Schols AM. Raised CRP levels mark metabolic and functional impairment in advanced COPD. Thorax. 2006;61:17-22.
  • 23. Agusti AG, Noguera A, Sauleda J, Sala E, Pons J, Busquets X. Systemic effects of chronic obstructive pulmonary disease. Eur Respir J 2003;21:347-60.
  • 24. Chatila WM, Thomashow BM, Minai OA, Criner GJ, Make BJ. Comorbidities in Chronic Obstructive Pulmonary Diseas. Proc Am Thorac Soc 2008;5:549-55.
  • 25. Barnes PJ, Celli BR. Systemic manifestations and comorbidities of COPD Eur Respir J 2009; 33:1165-85.
  • 26. 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;Epub 2010 Dec 21.
  • 27. Das SR, Alexander KP, Chen AY, Powell-Wiley TM, Diercks DB, Peterson ED, et al. Impact of Body Weight and Extreme Obesity on the Presentation, Treatment, and In-Hospital Outcomes of 50,149 Patients With ST-Segment Elevation Myocardial Infarction Results From the NCDR (National Cardiovascular Data Registry). J Am Coll Cardiol 2011;58:2642-50.
  • 28. Franssen FM, O'Donnell DE, Goossens GH, Blaak EE, Schols AM. Obesity and the lung:5. Obesity and COPD. Thorax 2008;63:1110-7.
  • 29. Leone N, Courbon D, Thomas F, Bean K, Jégo B, Leynaert B, et al. Lung function impairment and metabolic syndrome the critical role of abdominal obesity. American Journal of Respiratory and Critical Care Medicine 2009; 179:509-16.
  • 30. Dandona P, Aljada A, Chaudhuri A, Mohanty P, Garg R. Metabolic Syndrome: A comprehensive Perspective Based on Interactions between Obesity Diabetes and Inflammation. Circulation 2005;111:1448-54.
  • 31. Xu H, Barnes GT, Yang Q. Chronic Inflammation in Fat Plays a Crucial role in development of obesity related insulin resistance. J Clin Invest 2003;112:1821-30.
  • 32. 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;136:1039-46.
  • 33. Kern E. Metabolic syndrome and systemic inflammation in COPD. COPD 2011;8:395-6.
  • 34. Ozgen Alpaydin A, Konyar Arslan I, Serter S, Sakar Coskun A, Celik P, Taneli F, Yorgancioglu A. Metabolic syndrome and carotid intimamedia thickness in chronic obstructive pulmonary disease. Multidiscip Respir Med. 2013;8:61.
  • 35. Akpinar EE, Akpinar S, Ertek S, Sayın E, Gulhan M. Systemic inflammation and metabolic syndrome in stable COPD patients. Tuberk Toraks 2012;60(3):230-237.

METABOLIC SYNDROME AND CHRONIC DISEASES IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Yıl 2015, Cilt: 29 Sayı: 2, 75 - 84, 01.10.2015

Öz

Aim: Results of the previous studies on the relationship amongst the comorbidity, metabolic syndrome (MS) and Chronic Obstructive Pulmonary Disease (COPD) are controversial. Therefore, these accompanying comorbidities and MS were assessed on an individual basis in patients with COPD in the present study. Method: During the study period, 66 consecutive patients with COPD and 40 subjects as a control group were enrolled. Pulmonary Function Tests (PFT) were performed with flow sensitive spirometer according to ATS guidelines. The Body-Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity (BODE) index was calculated. The index severity of chronic diseases was evaluated using the Modified Cumulative Illness Rating Scale (MCIRS). MS was defined according to National Cholesterol Education Program. Total score of metabolic disorders was also calculated. Results: MCIRS score was significantly greater in patients with COPD than in control group but the total score of metabolic disorders was the same for the patients with COPD and the control group. MS was detected in 18 subjects (27.3%) in patients with COPD as compared to 8 of subjects in control group (20%). The rate of MS in patients with stage II COPD was higher than the patients with stage IV COPD (p: 0.04). In linear regression model, the MCIRS score exhibited significant inverse associations with FEV1%, FVC% and FEV1/FVC% while exhibiting significant positive association with BODE index. However, the MCIRS did not exhibit significant association with PO2. Conclusion: Comorbidities and MS were seen in different stages of COPD. Thus these accompanying diseases should be assessed on an individual basis.

Kaynakça

  • 1. Barnes PJ, Celli BR. Systemic manifestations and comorbidities of COPD. Eur Respir J 2009;33:1165-85.
  • 2. Sidney S, Sorel M, Quesenberry CP Jr, DeLuise C, Lanes S, Eisner MD. COPD and incident cardiovascular disease hospitalizations and mortality:Kaiser Permanente medical care program. Chest 2005;128:2068-75.
  • 3. Chatila WM, Thomashow BM, Minai OA, Criner GJ, Make BJ. Comorbidities in chronic obstructive pulmonary disease. Proc Am Thorac Soc 2008;5:549-55.
  • 4. Soriano JB, Visick GT, Muellerova H, Payvandi N, Hansell AL. Patterns of comorbidities in newly diagnosed COPD and asthma in primary care. Chest 2005;128:2099-107.
  • 5. Valdes AM, Andrew T, Gardner JP, Kimura M, Oelsner E, Cherkas LF, et al. Obesity, cigarette smoking, and telomere length in women. Lancet 2005;366:662-4.
  • 6. Luppi F, Franco F, Beghé B, Fabbri LM. Treatment of Chronic Obstructive Pulmonary Disease and Its ComorbiditiesProc Am Thorac Soc 2008;5:848-56.
  • 7. Parameswaran K, Todd DC, Soth M. Altered respiratory physiology in obesity. Can Respir J 2006; 13:203-10.
  • 8. Cecere LM, Littman AJ, Slatore CG, Udris EM, Bryson CL, Boyko EJ, et al. Obesity and COPD:associated symptoms, health-related quality of life, and medication use. COPD 2011; 8:275-84.
  • 9. Dandona P, Aljada A, Chaudhuri A, Mohanty P, Garg R. Metabolic syndrome:a comprehensive based on interactions between obesity, diabetes, and inflammation. Circulation 2005; 111:1448-54.
  • 10. Spurzem JR, Rennard Sl. Pathogenesis of COPD. Semin Respir Crit Care Med 2005; 26:142-53.
  • 11. Donaldson GC, Seemungal TA, Patel IS, Bhowmik A, Wilkinson TM, Hurst JR, et al.Airway and systemic inflammation and decline in lung function in patients with COPD. Chest 2005; 128:1995-2004.
  • 12. Čekerevac I, Lazić Z.Obesity and chronic obstructive pulmonary disease. Srp Arh Celok Lek 2011;139:322-7.
  • 13. King DA, Cordova F, Scharf SM. Nutritional Aspects of Chronic Obstructive Pulmonary Disease. Proc Am Thorac Soc 2008;5:519-23.
  • 14. Global Strategy of Diagnosis, Management and Prevention of COPD. 2006. http://www.goldcopd. org. Date last updated:December 2009.
  • 15. Standardization of spirometry. Statement of the American Thoracic Society. Am Rev Respir Dis 1987;136:1285-98.
  • 16. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute;National High Blood Pressure Education Program Coordinating Committee. Hypertension. 2003;42:1206-52.
  • 17. American Thoracic Society. ATS Statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002;166:111-7.
  • 18. Bestall JC, Paul EA, Garrod R, Garnham R, Jones PW, Wedzicha JA. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax 1999;54:581-6.
  • 19. Celli BR, Cote CG, Marin JM, Casanova C, Montes de Oca M, Mendez RA, et al. The bodymass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med 2004; 350:1005-12.
  • 20. Miller MD, Paradis CF, Houck PR, Mazumdar S, Stack JA, Rifai AH, et al. Rating chronic medical illness burden in geropsychiatric practice and research:application of the Cumulative Illness Rating Scale. Psychiatry Res 1992;41:237-48.
  • 21. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001; 285:2486-97.
  • 22. Broekhuizen R, Wouters EF, Creutzberg EC, Schols AM. Raised CRP levels mark metabolic and functional impairment in advanced COPD. Thorax. 2006;61:17-22.
  • 23. Agusti AG, Noguera A, Sauleda J, Sala E, Pons J, Busquets X. Systemic effects of chronic obstructive pulmonary disease. Eur Respir J 2003;21:347-60.
  • 24. Chatila WM, Thomashow BM, Minai OA, Criner GJ, Make BJ. Comorbidities in Chronic Obstructive Pulmonary Diseas. Proc Am Thorac Soc 2008;5:549-55.
  • 25. Barnes PJ, Celli BR. Systemic manifestations and comorbidities of COPD Eur Respir J 2009; 33:1165-85.
  • 26. 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;Epub 2010 Dec 21.
  • 27. Das SR, Alexander KP, Chen AY, Powell-Wiley TM, Diercks DB, Peterson ED, et al. Impact of Body Weight and Extreme Obesity on the Presentation, Treatment, and In-Hospital Outcomes of 50,149 Patients With ST-Segment Elevation Myocardial Infarction Results From the NCDR (National Cardiovascular Data Registry). J Am Coll Cardiol 2011;58:2642-50.
  • 28. Franssen FM, O'Donnell DE, Goossens GH, Blaak EE, Schols AM. Obesity and the lung:5. Obesity and COPD. Thorax 2008;63:1110-7.
  • 29. Leone N, Courbon D, Thomas F, Bean K, Jégo B, Leynaert B, et al. Lung function impairment and metabolic syndrome the critical role of abdominal obesity. American Journal of Respiratory and Critical Care Medicine 2009; 179:509-16.
  • 30. Dandona P, Aljada A, Chaudhuri A, Mohanty P, Garg R. Metabolic Syndrome: A comprehensive Perspective Based on Interactions between Obesity Diabetes and Inflammation. Circulation 2005;111:1448-54.
  • 31. Xu H, Barnes GT, Yang Q. Chronic Inflammation in Fat Plays a Crucial role in development of obesity related insulin resistance. J Clin Invest 2003;112:1821-30.
  • 32. 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;136:1039-46.
  • 33. Kern E. Metabolic syndrome and systemic inflammation in COPD. COPD 2011;8:395-6.
  • 34. Ozgen Alpaydin A, Konyar Arslan I, Serter S, Sakar Coskun A, Celik P, Taneli F, Yorgancioglu A. Metabolic syndrome and carotid intimamedia thickness in chronic obstructive pulmonary disease. Multidiscip Respir Med. 2013;8:61.
  • 35. Akpinar EE, Akpinar S, Ertek S, Sayın E, Gulhan M. Systemic inflammation and metabolic syndrome in stable COPD patients. Tuberk Toraks 2012;60(3):230-237.
Toplam 35 adet kaynakça vardır.

Ayrıntılar

Diğer ID JA57VT72CY
Bölüm Araştırma Makalesi
Yazarlar

Emel Bulcun Bu kişi benim

Aydanur Ekici Bu kişi benim

Mehmet Ekici Bu kişi benim

Yayımlanma Tarihi 1 Ekim 2015
Yayımlandığı Sayı Yıl 2015 Cilt: 29 Sayı: 2

Kaynak Göster

APA Bulcun, E., Ekici, A., & Ekici, M. (2015). KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞINDA METABOLİK SENDROM VE KRONİK HASTALIKLAR. İzmir Göğüs Hastanesi Dergisi, 29(2), 75-84.