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患有和未患有代谢综合征的慢性阻塞性肺疾病患者:临床和功能差异

COPD patients with and without metabolic syndrome: clinical and functional differences.

作者信息

Díez-Manglano Jesús, Barquero-Romero José, Almagro Pedro, Cabrera Francisco Javier, López García Francisco, Montero Lorena, Soriano Joan Baptiste

机构信息

Internal Medicine Service, Hospital Royo Villanova, Avda San Gregorio no 30, 50015, Saragossa, Spain,

出版信息

Intern Emerg Med. 2014 Jun;9(4):419-25. doi: 10.1007/s11739-013-0945-7. Epub 2013 May 5.

Abstract

Chronic obstructive pulmonary disease (COPD) and the metabolic syndrome (MetS) are considered public health challenges of the 21st century. The coexistence of MetS in COPD patients and any clinical differences between COPD patients with and without MetS have not been extensively studied. We aimed to describe the clinical characteristics of patients with MetS and COPD. An observational, multicenter study of 375 patients hospitalized for a COPD exacerbation with spirometric confirmation was performed. We measured the components of the MetS and collected comorbidity information using the Charlson index and other conditions. Dyspnea, use of steroids, exacerbations, and hospitalizations were also investigated. The overall prevalence of MetS in COPD patients was 42.9 %, was more frequent in women (59.5 %) than men (40.8 %), p = 0.02, but with no differences in age and smoking history. COPD patients with MetS had greater % predicted FEV1, more dyspnea, and more comorbidity and used more inhaled steroids (all p < 0.05). Diabetes, osteoporosis, coronary artery disease, and heart failure were more frequent in patients with MetS. They had been hospitalized more frequently for any cause but not for COPD. In multivariate analysis, the presence of MetS was independently associated with greater FEV1, inhaled steroids use, osteoporosis, diabetes, and heart failure. MetS is a frequent condition in COPD patients, and it is associated with greater FEV1, more dyspnea, and more comorbidities.

摘要

慢性阻塞性肺疾病(COPD)和代谢综合征(MetS)被视为21世纪的公共卫生挑战。COPD患者中代谢综合征的共存情况以及合并和未合并代谢综合征的COPD患者之间的任何临床差异尚未得到广泛研究。我们旨在描述合并代谢综合征和COPD的患者的临床特征。对375例因COPD急性加重住院且经肺量计确认的患者进行了一项观察性多中心研究。我们测量了代谢综合征的各项指标,并使用查尔森指数和其他情况收集了合并症信息。还对呼吸困难、类固醇使用情况、急性加重和住院情况进行了调查。COPD患者中代谢综合征的总体患病率为42.9%,女性(59.5%)比男性(40.8%)更常见,p = 0.02,但在年龄和吸烟史方面无差异。合并代谢综合征的COPD患者预测的FEV1百分比更高、呼吸困难更严重、合并症更多且吸入类固醇使用更多(所有p < 0.05)。糖尿病、骨质疏松症、冠状动脉疾病和心力衰竭在合并代谢综合征的患者中更常见。他们因任何原因住院的频率更高,但因COPD住院的频率不高。在多变量分析中,代谢综合征的存在与更高的FEV1、吸入类固醇使用、骨质疏松症、糖尿病和心力衰竭独立相关。代谢综合征在COPD患者中很常见,并且与更高的FEV1、更严重的呼吸困难和更多的合并症相关。

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