Yıl: 2012 Cilt: 60 Sayı: 3 Sayfa Aralığı: 230 - 237 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Systemic inflammation and metabolic syndrome in stable COPD patients

Öz:
Giriş: Kronik obstrüktif akciğer hastalığı (KOAH) sistemik inflamasyonla ilişkili gibi görünen ekstrapulmoner etkilere sa- hiptir. Genel popülasyonda sistemik inflamasyonun önemli belirleyicilerinden biri olan metabolik sendromla KOAH arasın- daki ilişki henüz netleşmemiştir. Bu çalışmanın amacı; farklı evrelerdeki stabil KOAH’lı hastalarda ve yaş, cinsiyet açısın- dan eşleştirilmiş kontrol grubunda metabolik sendrom frekansını ve sistemik inflamasyon belirteci olan C-reaktif protein (CRP) düzeylerini değerlendirmektir. Hastalar ve Metod: Çalışmaya 91 stabil KOAH’lı hasta ve 42 kontrol birey alındı. KOAH ağırlığı GOLD (Global Initiative for Chronic Obstructive Lung Disease) kriterlerine göre belirlendi. Metabolik sendrom tanısında ATP III (The National Choleste- rol Education Program’s Adult Treatment Panel III) kriterleri kullanıldı. Hasta ve kontrol grubunda alınan venöz kan örne- ğinde CRP düzeyleri ölçüldü. Bulgular: Metabolik sendrom frekansı hasta grubunda, özellikle GOLD I, II’de, kontrol grubundan daha yüksek bulundu (p= 0.004). Metabolik sendromun abdominal obezite, hipertansiyon ve hiperglisemi komponentlerinin frekansı hasta grubunda daha yüksek bulundu (p< 0.0001). Artmış CRP düzeyleri kontrol grubunda ve hasta grubun tüm evrelerinde, metabolik sendrom olanlarda, olmayanlara göre daha yüksek orandaydı (p= 0.047, p= 0.217, p< 0.001, p= 0.05, p= 0.467). Sonuç: Bu çalışma metabolik sendrom frekansının stabil KOAH’lı hastalarda, kontrol grubundan ve Türk popülasyonun- dan daha yüksek olduğunu göstermiştir. Abdominal obezite, hipertansiyon ve hiperglisemi hasta grubunda anlamlı dere- cede daha sıktı. Sistemik inflamasyon metabolik sendromu olan KOAH’lı hastalarda olmayanlara göre daha yoğundu.
Anahtar Kelime:

Konular: Solunum Sistemi Kulak, Burun, Boğaz

Stabil KOAH’lı hastalarda sistemik inflamasyon ve metabolik sendrom

Öz:
Introduction: Chronic obstructive pulmonary disease (COPD) has extrapulmonary effects that seems to be related with systemic inflammation. The relationship between metabolic syndrome which is an important determinant of systemic inf- lammation in general population and COPD is still not clear. The aim of the current study was to investigate the frequency of metabolic syndrome and C-reactive protein (CRP) levels, as a marker of systemic inflammation in stable COPD patients with different severity levels and in age and sex matched control group. Patients and Methods: Ninety-one stable COPD patients and 42 control subjects were included in the study. The severity level in patients with COPD were determined according to GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteria. ATP III (The National Cholesterol Education Program&#8217;s Adult Treatment Panel III) was used in diagnosis of metabo- lic syndrome. Hs-CRP levels were measured in venous samples of patients and control subjects. Results: The frequency of metabolic syndrome was found higher in patient group than control subjects, especially in GOLD stages I, II (p= 0.004). Abdominal obesity, hypertension, hyperglycemia components of metabolic syndrome were signifi- cantly more prevalent in patient group (p< 0.0001). Increased CRP levels were higher in control and patient groups in all GOLD stages, with metabolic syndrome than without metabolic syndrome (p= 0.047, p= 0.217, p< 0.001, p= 0.05, p= 0.467). Conclusion: The study showed that frequency of metabolic syndrome was higher in stable COPD patients than control sub- jects and general Turkish population. Abdominal obesity, hypertension and hyperglycemia were significantly more preva- lent in patient group. Systemic inflammation was more intense in COPD patients with metabolic syndrome than without metabolic syndrome.
Anahtar Kelime:

Konular: Solunum Sistemi Kulak, Burun, Boğaz
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. From the Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) Updated 2008. Available from: http://www.goldcopd.org/
  • 2. Fabbri LM, Rabe K. From COPD to chronic systemic inflammatory syndrome? Lancet 2007; 370: 797-99.
  • 3. Sin DD, Anthonisen NR, Soriano JB, Agusti AG. Mortality in COPD: role of co morbidities. Eur Respir J 2006; 28: 1245-57.
  • 4. Mannino DM, Thorn D, Swensen A, Holguin F. Prevalence and outcomes of diabetes, hypertension and cardiovascular disease in COPD. Eur Respir J 2008; 32: 962-9.
  • 5. Gan WQ, Man SF, Senthilselvan A, Sin DD. Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis. Thorax 2004; 59: 574-80.
  • 6. Magnussen H, Watz H. Systemic inflammation in chronic obstructive pulmonary disease and asthma: relation with co morbidities. Proc Am Thorac Soc 2009; 6: 648-51.
  • 7. Isomaa B, Almgren P, Tuomi T, Forsen B, Lahti K, Nissen M, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001; 24: 683-9.
  • 8. Haffner SM, Valdez RA, Hazuda HP, Mitchell BD, Morales PA, Stern MP. Prospective analysis of the insulin-resistance syndrome (syndrome X). Diabetes 1992; 41: 715-22.
  • 9. Watz H, Waschki B, Kirsten A, Müler KC, Kretschmar G, Meyer T, et al. The metabolic syndrome in patients with chronic bronchitis and COPD. Chest 2009; 136: 1039-46.
  • 10. Lam KB, Jordan RE, Jiang CQ, Thomas GN, Miller MR, Zhang WS, et al. Airflow obstruction and metabolic syndrome: the Guangzhou Biobank Cohort Study. Eur Respir J 2010; 35: 317-23.
  • 11. Sutherland JP, McKinley B, Eckel RH. The metabolic syndrome and inflammation. Metab Syndr Relat Disord 2004; 2: 82-204.
  • 12. Marquis K, Maltais F, Duguay V, Bezeau AM, LeBlanc P, Jobin J, et al. Metabolic syndrome in patients with chronic obstructive pulmonary disease. J Cardiopulm Rehabil 2005; 25: 226-32.
  • 13. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 2002; 287: 356-9.
  • 14. Bolton CE, Evans M, Ionescu A, Edwards SM, Morris RH, Luzio S, et al. İnsulin resistance and inflammation-a further systemic complication of COPD. COPD 2007; 4: 121-6.
  • 15. Perloff D, Grim C, Flack J, Frohlich ED, Hill M, McDonald M, et al. Human blood pressure determination by sphygmomanometer. Circulation 1993; 88: 2460-70.
  • 16. Lohmann T, Roche ARM. The Airlie (VA) consensus: standardization of anthropometric measurements. Human Kinetic Publishers, Champaign IL, 1988: 39-80.
  • 17. Grundy SM, Brewer HB, Cleeman JI, Smith SC, Lenfant C. For the Conference Participants. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association Conference on Scientific Issues Related to Definition. Circulation 2004; 109: 433-8.
  • 18. Nussbaumer-Ochsner Y, Rabe KF. Systemic manifestations of COPD. Chest 2011; 139: 165-73.
  • 19. Barnes PJ, Celli BR. Systemic manifestations and co morbidities of COPD. Eur Respir J 2009; 33: 1165-85.
  • 20. Fabbri LM, Luppi F, Beghé B, Rabe KF. Complex chronic co morbidities of COPD. Eur Respir J 2008; 31: 204-12.
  • 21. Gan WQ, Man SF, Senthilselvan A, Sin DD. Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis. Thorax 2004; 59: 574-80.
  • 22. Hurst JR, Vestbo J, Anzueto Locantore N, Müllerova H, Tal-Singer R, Miller B, et al. for the ECLIPSE Investigators: Susceptibility to exacerbation in chronic obstructive pulmonary disease. N Engl J Med 2010; 363: 1128-38.
  • 23. De Torres JP, Pinto-Plata V, Casanova C. C-reactive protein levels and survival in patients with moderate to very severe COPD. Chest 2008; 1333: 1336-43.
  • 24. Dahl M, Vestbo J, Lange P, Bojesen SE, Tybjaerg-Hansen A, Nordestgaard BG. C-reactive protein as a predictor of prognosis in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2007; 175: 250-5.
  • 25. Stanciu S, Marinescu R, Iordache M, Dumitrescu S, Mureşan M, Boğdan MA. Are systemic inflammatory profiles different in patients with COPD and metabolic syndrome as compared to those with COPD alone? Rom J Intern Med 2009; 47: 381-6.
  • 26. Sanisoğlu SY, Oktenli C, Hasimi A, Yokusoğlu M. Prevalence of metabolic syndrome-related disorders in a large adult population in Turkey. BMC Public Health 2006; 6: 92. doi:10.1186/1471-2458-6-92
  • 27. Gemalmaz A, Aydın S, Başak O, Disçigil G, Korul A. Prevalence of the metabolic syndrome in a rural Turkish population: comparison and concordance of two diagnostic criteria. Turk J Med Sci 2008; 38: 159-65.
  • 28. Gündoğan K, Bayram F, Capak M, Tanrıverdi F, Karaman A, Ozturk A, et al. Prevalence of metabolic syndrome in the Mediterranean region of Turkey: evaluation of hypertension, diabetes mellitus, obesity, and dyslipidemia. Metab Syndr Relat Disord 2009; 7: 427-34.
  • 29. Barr RG, Celli BR, Mannino DM. Comorbidities, patient knowledge, and disease management in a national sample of patients with COPD. Am J Med 2009; 122: 348-55.
  • 30. Fantuzzi G. Adipose tissue, adipokines, and inflammation. J Allergy Clin Immunol 2005; 115: 911-9.
  • 31. Poulain M, Doucet M, Drapeau V, Fournier G, Tremblay A, Poirier P, et al. Metabolic and inflammatory profile in obese patients with chronic obstructive pulmonary disease. Chronic Respiratory Disease 2008; 5: 34-41.
  • 32. Yeh HC, Punjabi NM, Wang NY, Pankow JS, Duncan BB, Cox CE, et al. Cross-sectional and prospective study of lung function in adults with type 2 diabetes: the Atherosclerosis Risk in Communities (ARIC) study. Diabetes Care 2008; 31: 741-6.
  • 33. Gudmundsson G, Gislason T, Lindberg E, Hallin R, Ulrik CS, Brondum E. Mortality in COPD patients discharged from hospital: the role of treatment and co-morbidity. Respir Res 2006; 7: 109-16.
  • 34. Hotamisligil GS. Inflammation and metabolic disorders. Nature 2006; 444: 860-7.
  • 35. Karadağ F, Kirdar S, Karul AB, Ceylan E. The value of C-reactive protein as a marker of systemic inflammation in stable chronic obstructive pulmonary disease. Eur J Intern Med 2008; 19: 104-8.
  • 36. Broekhuizen R, Wouters EFM, Creutzberg EC, Schols AMWJ. Raised CRP levels mark metabolic and functional impairment in advanced COPD. Thorax 2006; 61: 17-22.
  • 37. Gläser S, Ittermann T, Koch B, Völzke H, Wallaschofski H, Nauck M, et al. Airflow limitation, lung volumes and systemic inflammation in a general population. Eur Respir J 2012; 39: 29-37.
APA AKPINAR E, AKPINAR S, ERTEK S, SAYIN E, Gulhan M (2012). Systemic inflammation and metabolic syndrome in stable COPD patients. , 230 - 237.
Chicago AKPINAR Evrim Eylem,AKPINAR Serdar,ERTEK Sibel,SAYIN Esen,Gulhan Meral Systemic inflammation and metabolic syndrome in stable COPD patients. (2012): 230 - 237.
MLA AKPINAR Evrim Eylem,AKPINAR Serdar,ERTEK Sibel,SAYIN Esen,Gulhan Meral Systemic inflammation and metabolic syndrome in stable COPD patients. , 2012, ss.230 - 237.
AMA AKPINAR E,AKPINAR S,ERTEK S,SAYIN E,Gulhan M Systemic inflammation and metabolic syndrome in stable COPD patients. . 2012; 230 - 237.
Vancouver AKPINAR E,AKPINAR S,ERTEK S,SAYIN E,Gulhan M Systemic inflammation and metabolic syndrome in stable COPD patients. . 2012; 230 - 237.
IEEE AKPINAR E,AKPINAR S,ERTEK S,SAYIN E,Gulhan M "Systemic inflammation and metabolic syndrome in stable COPD patients." , ss.230 - 237, 2012.
ISNAD AKPINAR, Evrim Eylem vd. "Systemic inflammation and metabolic syndrome in stable COPD patients". (2012), 230-237.
APA AKPINAR E, AKPINAR S, ERTEK S, SAYIN E, Gulhan M (2012). Systemic inflammation and metabolic syndrome in stable COPD patients. Tüberküloz ve Toraks, 60(3), 230 - 237.
Chicago AKPINAR Evrim Eylem,AKPINAR Serdar,ERTEK Sibel,SAYIN Esen,Gulhan Meral Systemic inflammation and metabolic syndrome in stable COPD patients. Tüberküloz ve Toraks 60, no.3 (2012): 230 - 237.
MLA AKPINAR Evrim Eylem,AKPINAR Serdar,ERTEK Sibel,SAYIN Esen,Gulhan Meral Systemic inflammation and metabolic syndrome in stable COPD patients. Tüberküloz ve Toraks, vol.60, no.3, 2012, ss.230 - 237.
AMA AKPINAR E,AKPINAR S,ERTEK S,SAYIN E,Gulhan M Systemic inflammation and metabolic syndrome in stable COPD patients. Tüberküloz ve Toraks. 2012; 60(3): 230 - 237.
Vancouver AKPINAR E,AKPINAR S,ERTEK S,SAYIN E,Gulhan M Systemic inflammation and metabolic syndrome in stable COPD patients. Tüberküloz ve Toraks. 2012; 60(3): 230 - 237.
IEEE AKPINAR E,AKPINAR S,ERTEK S,SAYIN E,Gulhan M "Systemic inflammation and metabolic syndrome in stable COPD patients." Tüberküloz ve Toraks, 60, ss.230 - 237, 2012.
ISNAD AKPINAR, Evrim Eylem vd. "Systemic inflammation and metabolic syndrome in stable COPD patients". Tüberküloz ve Toraks 60/3 (2012), 230-237.