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Obstructive Lung Diseases |

Chronic Obstructive Pulmonary Disease (COPD) and Metabolic Disorders in Elderly Smokers

Alessia Verduri, PhD; Giorgia Gibellini, MD; Sara Balduzzi, PhD; Martina Garofalo, MD; Monica Bortolotti, MD; Enrico Clini, MD; Leonardo Fabbri, MD; Bianca Beghé, PhD
Author and Funding Information

Respiratory Unit - University of Modena and Reggio Emilia, Modena, Italy


Chest. 2013;144(4_MeetingAbstracts):692A. doi:10.1378/chest.1702685
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Abstract

SESSION TITLE: COPD Diagnosis & Evaluation Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: We examined the prevalence of metabolic syndrome (MS) in elderly heavy smokers COPD patients, enrolled in a study assessing the influence of COPD comorbidities.

METHODS: We studied 84 COPD outpatients (according to GOLD guidelines), aged ≥65 yrs, ≥20 pack/years, for MS, Hemoglobin A1c (HbA1c), fasting insulin, and interleukin-6 (IL-6). MS was assessed according to the IDF criteria (Diabet Med 2006;23:469-80). Body Mass Index (BMI) and HOMA (Homeostatic Model Assessment) index were also calculated.

RESULTS: Patients had mean age 72 yrs (range 65-82; male 76%), mean pack/years 51 (range 20-150;74% former smokers, 26% current smokers). According to spirometry classification, 15 patients were GOLD I, 39 II, 28 III, 2 IV. Eighty-eight% patients had one or more chronic comorbidities, the commonest were hypertension (65%), ischemic heart disease (23%), depression (19%), diabetes (12%), osteoporosis (12%). The prevalence of MS was 58%; hypoglycemic agents, statins or antihypertensive drugs were used by 44 patients, while 5 patients (10%) were not treated for each component of MS. MS was not associated with aging and COPD severity. Interestingly, 25 patients had HbA1c ≥6.5%: 8 had type-2 diabetes (T2D) and 17 no previous diagnosis of diabetes and/or treatment with hypoglycemic agents. Patients with HbA1c ≥6-6.49% were 26 (2 with T2D). No association was found between COPD severity and HbA1c value, which instead correlated with the waist circumference. A weak positive significant association (p=<0.001,r=0.3831) between HOMA index and waist circumference, and a statistically significant association (p=0.0001) between HOMA index and BMI were found. The greater was spirometry severity, the higher the levels of IL-6, even if the comparison among classes did not reach the statistical difference.

CONCLUSIONS: These results confirm the high prevalence of MS, often under-estimated, and the presence of subclinical T2D in up to 20% of elderly heavy smokers COPD patients. HbA1c values of ≥6-6.49% identified COPD patients at high risk of T2D.

CLINICAL IMPLICATIONS: The high prevalence of MS and subclinical T2D suggest that metabolic disorders should be routinely searched in COPD patients for improving management of patients with COPD. Funded by Ministero Salute and Chiesi Foundation.

DISCLOSURE: The following authors have nothing to disclose: Alessia Verduri, Giorgia Gibellini, Sara Balduzzi, Martina Garofalo, Monica Bortolotti, Enrico Clini, Leonardo Fabbri, Bianca Beghé

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