Systemic inflammation in patients of chronic obstructive pulmonary disease with metabolic syndrome

India has 18% of the global population and an increasing burden of chronic respiratory diseases. The prevalence of Metabolic syndrome (MS) was found to be as high as 39.7% among Indian population. Metabolic syndrome is found to be more common in Chronic Obstructive Pulmonary Disease (COPD) when compared to the general population. This study was done to assess the prevalence of metabolic syndrome in COPD and the association of systemic inflammation in COPD patients with metabolic syndrome.

This study enrolled 150 consecutive consenting patients of stable COPD attending the outpatient pulmonology department. Detailed history, clinical examination, spirometry, and relevant routine laboratory investigations including complete blood count, fasting blood sugar, and lipid profile were done. In addition, hsCRP, Serum lactate and Vitamin D level was assessed in all patients. Diagnosis of COPD and Metabolic syndrome was done according to GOLD guidelines, 2018 and the International Diabetes Federation criteria respectively.

The prevalence of metabolic syndrome was found to be 27.3% in our COPD patients. The frequency of metabolic syndrome in GOLD stage I, II, III, and IV was 75%, 32%, 17%, and 13.5%, respectively. Logistic regression analysis showed a significant relationship of blood leucocyte count (OR = 0.342, CI = 0.171-0.686), hs-CRP (OR = 0.020, CI = 0.003-0.122), pack years (OR = 1.083, CI = 1.026-1.14) and vitamin D levels (OR = 1.219, CI = 1.093-1.359) with metabolic syndrome in COPD patients.

Metabolic syndrome is a co-morbidity that is very often overlooked in patients of COPD. Systemic inflammation which is a common characteristic of both COPD and Metabolic syndrome has been found to be an important contributor towards cardiovascular morbidity and mortality.