Piazzolla Giuseppina, Castrovilli Anna, Liotino Vito, Vulpi Maria Rosaria, Fanelli Margherita, Mazzocca Antonio, Candigliota Mafalda, Berardi Elsa, Resta Onofrio, Sabbà Carlo, Tortorella Cosimo
Interdisciplinary Department of Medicine, University of Bari School of Medicine, Bari, Italy.
Department of Cardiac, Thoracic and Vascular Science, University of Bari School of Medicine, Bari, Italy.
PLoS One. 2017 Oct 24;12(10):e0186708. doi: 10.1371/journal.pone.0186708. eCollection 2017.
A close relationship between Metabolic Syndrome (MetS) and Chronic Obstructive Pulmonary Disease (COPD) has been described, but the exact nature of this link remains unclear. Current epidemiological data refer exclusively to the MetS prevalence among patients with COPD and data about the prevalence of COPD in MetS patients are still unavailable.
To analyse and compare risk factors, clinical and metabolic characteristics, as well as the main respiratory function parameters, among patients affected by MetS, COPD or both diseases.
We recruited 59 outpatients with MetS and 76 outpatients with COPD. After medical history collection, physical examination, blood sampling for routine analysis, spirometric evaluation, they were subdivided into MetS (n = 46), MetS+COPD (n = 60), COPD (n = 29).
A MetS diagnosis was assigned to 62% of COPD patients recruited in the COPD Outpatients Clinic of the Pneumology Department, while the COPD prevalence in MetS patients enrolled in the Internal Medicine Metabolic Disorders Outpatients Clinic was 22%. More than 60% of subjects enrolled in each Department were unaware that they suffered from an additional disease. MetS+COPD patients exhibited significantly higher C-peptide levels. We also found a positive relation between C-peptide and pack-years in all subjects and a negative correlation between C-peptide and vitamin D only in current smokers. Finally, a negative association emerged between smoking and vitamin D.
We have estimated, for the first time, the COPD prevalence in MetS and suggest a potential role of smoking in inducing insulin resistance. Moreover, a direct effect of smoking on vitamin D levels is proposed as a novel mechanism, which may account for both insulin resistance and COPD development.
代谢综合征（MetS）与慢性阻塞性肺疾病（COPD）之间存在密切关系，但这种联系的确切性质仍不清楚。目前的流行病学数据仅涉及COPD患者中的MetS患病率，而关于MetS患者中COPD患病率的数据仍然缺乏。
分析和比较患有MetS、COPD或两种疾病的患者的危险因素、临床和代谢特征以及主要呼吸功能参数。
我们招募了59名患有MetS的门诊患者和76名患有COPD的门诊患者。在收集病史、进行体格检查、采集血样进行常规分析、进行肺功能评估后，他们被分为MetS组（n = 46）、MetS+COPD组（n = 60）、COPD组（n = 29）。
在呼吸内科门诊的COPD患者中，62%被诊断为患有MetS，而在内科代谢紊乱门诊的MetS患者中，COPD患病率为22%。每个科室超过60%的受试者不知道自己还患有另一种疾病。MetS+COPD患者的C肽水平显著更高。我们还发现，在所有受试者中，C肽与吸烟包年数呈正相关，仅在当前吸烟者中，C肽与维生素D呈负相关。最后，吸烟与维生素D之间呈现负相关。
我们首次估计了MetS患者中的COPD患病率，并提出吸烟在诱导胰岛素抵抗方面可能发挥的作用。此外，吸烟对维生素D水平的直接影响被认为是一种新机制，这可能解释胰岛素抵抗和COPD的发展。
