PURPOSE: Chronic Obstructive Pulmonary Disease (COPD) is a disease with systemic inflammation which may be associated with insulin resistance. We therefore studied insulin resistance in COPD patients.
METHODS: Fasting serum insulin (by solid phase two-site enzyme immunoassay), fasting glucose (by glucose oxidase-peroxidase) and insulin resistance (by Homeostasis Model Assessments (HOMA) were measured in 49 COPD and 14 healthy controls. COPD group was further divided in two groups- group 1(COPD with co-morbid conditions such as diabetes mellitus and/or hypertension, n=21) and group 2 (COPD without co-morbid conditions, n=28).
RESULTS: Compared with healthy controls, the mean body mass index (BMI) in kg/m2 was 23.07±4.5 vs 23.87±4.2 in group 1 (p=0.60) and 20.69±4.2 vs 23.87±4.2 in group 2 (p=0.03); mean insulin resistance values expressed as HOMA-IR units were 9.0 ± 8.7 vs 3.0 ± 2.9 (p=0.04) in Group 1 and 6.5 ± 5.6 vs 3.0 ± 2.9 (p=0.02) in Group 2; mean serum insulin levels in IU/ml were 37.6 ± 38.0 vs 14.9 ± 14.1 in Group 1 (p=0.05) and 28.3 ± 23.08 vs 14.9 ± 14.1 (p=0.05) in group 2 and the mean fasting glucose value in mg/dl was 101.9 ± 22.6 vs 85 ± 14.9 in group 1 (0.01) and 91.4 ± 12.7 vs 85 ± 14.9 in group 2 (p=0.04).
CONCLUSION: Inspite of having significantly lower mean values of BMI and higher mean values of serum insulin, the COPD patients without any co-morbidity had paradoxically high mean fasting blood glucose levels. This may be due to high mean values of insulin resistance in this group thereby suggesting COPD may be a risk factor for the development of insulin resistance and subsequent development of metabolic syndrome.
CLINICAL IMPLICATIONS: Early detection of insulin resistance is essential to prevent subsequent development of co-morbidities like diabetes mellitus in COPD patients.
DISCLOSURE: Shweta Bansal, No Financial Disclosure Information; No Product/Research Disclosure Information