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Clinical and Functional Heterogeneity of COPD Phenotypes: A Multicenter Study from Turkey (DIPTUR Study)
Tevfik Ozlu1, Ozlem Sengoren Dikis2, Fulden Cantas Turkis3
1Department of Pulmonary Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon 61080, Turkey.
Medicina (Kaunas, Lithuania)
|February 27, 2026
Summary
Chronic obstructive pulmonary disease (COPD) phenotypes in Turkey vary significantly. Exacerbator phenotypes, like exacerbator with emphysema (EE) and exacerbator with chronic bronchitis (ECB), show higher disease burden and healthcare needs.
Area of Science:
- Pulmonology
- Clinical Medicine
- Respiratory Medicine
Background:
- Chronic obstructive pulmonary disease (COPD) is a heterogeneous condition.
- Phenotype-based classification may offer better insights into clinical burden and healthcare needs compared to standard GOLD categories.
- Understanding COPD phenotypes in specific populations, like Turkey, is crucial for tailored management.
Purpose of the Study:
- To determine the distribution of GesEPOC COPD phenotypes in Turkey.
- To compare demographic, clinical, functional, radiological, treatment, and healthcare utilization profiles across these phenotypes.
Main Methods:
- A multicenter, observational, cross-sectional study (DIPTUR) involving 894 stable COPD patients across 26 centers in Turkey.
- Patients were classified into GesEPOC phenotypes: exacerbator with emphysema (EE), exacerbator with chronic bronchitis (ECB), asthma-COPD overlap (ACO), and non-exacerbator (NE).
- Data collected included demographics, smoking status, comorbidities, pulmonary function tests, CT imaging, exacerbation history, and healthcare utilization.
Main Results:
- The phenotype distribution was NE (44.1%), ECB (26.2%), EE (20.5%), and ACO (9.3%).
- Exacerbator phenotypes (EE and ECB) exhibited lower pulmonary function, higher rates of dyspnea, greater comorbidity prevalence (hypertension, diabetes, heart failure), and increased healthcare utilization (hospitalizations, emergency admissions).
- Emphysematous changes were predominant in EE (91.7%), and long-term oxygen therapy was most common in EE (32.4%).
Conclusions:
- COPD phenotypes in Turkey display significant heterogeneity across clinical, functional, radiological, and healthcare utilization aspects.
- Exacerbator phenotypes, particularly EE and ECB, represent high-burden patient groups.
- Phenotype-oriented management and closer monitoring beyond the GOLD classification are supported by these findings.
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