[COPD and endocrine and metabolic alterations].

The clinical course and therapeutic management of chronic obstructive pulmonary disease (COPD) may be affected by the presence of comorbid diseases, which also usually worsen prognosis. Among the endocrinological and metabolic alterations that can be associated with COPD are diabetes mellitus, osteoporosis, metabolic syndrome and malnutrition. There are several possible etiopathogenic mechanisms that intervene in the association between COPD and distinct endocrine and metabolic disorders, such as smoking and systemic inflammation, influenced by distinct cytokines among other factors. The high-dose glucocorticosteroids used in the treatment of severe COPD and exacerbations are a major risk factor for the development of some metabolic alterations such as diabetes and osteoporosis. Study of patients with COPD should identify the possible coexisting endocrinological and metabolic alterations in order to apply preventive measures and treatment. In general, patients benefit from being included in a respiratory rehabilitation program with physical exercise and a balanced diet, in addition to appropriate drug treatment in each case. Certain measures such as avoiding smoking and sedentariness are also essential in the correct treatment of COPD.