From the Pulmonary Research Institute (Drs Watz, Waschki, Kirsten, Kretschmar, and Magnussen); Hospital Grosshansdorf (Drs Müller, Holz, and Magnussen); and University Lübeck (Dr Meyer)
Correspondence to: Henrik Watz, MD, Pulmonary Research Institute, Center for Pneumology and Thoracic Surgery, Hospital Grosshansdorf, Woehrendamm 80, D-22927 Grosshansdorf, Germany; e-mail: email@example.com
Financial/nonfinancial disclosures:The authors have reported to CHEST that no potential conflicts of interest exist with any companies_organizations whose products or services may be discussed in this article
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).
© 2010 American College of Chest Physicians
We thank Dr Scarlata and colleagues for their interest in our study results1 and the comments about possible mechanisms related to systemic inflammation. Dr Scarlata and colleagues argue that a restrictive component of lung function might contribute to the presence of systemic inflammation in our patients with a coexisting metabolic syndrome. We can exclude that such a restrictive component had that effect in our study population because no patient had a total lung capacity < 80%. We did not give the results of body plethysmography previously because they neither contribute to the severity of COPD according to the Global Initiative for Chronic Obstructive Pulmonary Disease nor are they part of the metabolic syndrome.
We appreciate the comment regarding the Charlson index. The Charlson index can indeed only give the information that comorbidities exist at all and it does not discriminate between different entities. However, to date there are 45 studies available that applied the Charlson index in patients with COPD. Therefore, it allows some level of comparison among different study populations.
We also appreciate the comment that the inflammatory status in COPD might be of multifactorial origin. It is our study that demonstrates the independent association of the metabolic syndrome, physical inactivity, and COPD with systemic inflammation.1 Therefore, we identified at least three conditions that might contribute to systemic inflammation in a population that was primarily classified according to severity of COPD.
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