Stabil KOAH’lı hastalarda sistemik inflamasyon ve metabolik sendrom

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) has extrapulmonary effects that seems to be related with systemic inflammation. The relationship between metabolic syndrome which is an important determinant of systemic inf- lammation in general population and COPD is still not clear. The aim of the current study was to investigate the frequency of metabolic syndrome and C-reactive protein (CRP) levels, as a marker of systemic inflammation in stable COPD patients with different severity levels and in age and sex matched control group. Patients and Methods: Ninety-one stable COPD patients and 42 control subjects were included in the study. The severity level in patients with COPD were determined according to GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteria. ATP III (The National Cholesterol Education Program’s Adult Treatment Panel III) was used in diagnosis of metabo- lic syndrome. Hs-CRP levels were measured in venous samples of patients and control subjects. Results: The frequency of metabolic syndrome was found higher in patient group than control subjects, especially in GOLD stages I, II (p= 0.004). Abdominal obesity, hypertension, hyperglycemia components of metabolic syndrome were signifi- cantly more prevalent in patient group (p< 0.0001). Increased CRP levels were higher in control and patient groups in all GOLD stages, with metabolic syndrome than without metabolic syndrome (p= 0.047, p= 0.217, p< 0.001, p= 0.05, p= 0.467). Conclusion: The study showed that frequency of metabolic syndrome was higher in stable COPD patients than control sub- jects and general Turkish population. Abdominal obesity, hypertension and hyperglycemia were significantly more preva- lent in patient group. Systemic inflammation was more intense in COPD patients with metabolic syndrome than without metabolic syndrome.

Özet

Giriş: Kronik obstrüktif akciğer hastalığı (KOAH) sistemik inflamasyonla ilişkili gibi görünen ekstrapulmoner etkilere sa- hiptir. Genel popülasyonda sistemik inflamasyonun önemli belirleyicilerinden biri olan metabolik sendromla KOAH arasın- daki ilişki henüz netleşmemiştir. Bu çalışmanın amacı; farklı evrelerdeki stabil KOAH’lı hastalarda ve yaş, cinsiyet açısın- dan eşleştirilmiş kontrol grubunda metabolik sendrom frekansını ve sistemik inflamasyon belirteci olan C-reaktif protein (CRP) düzeylerini değerlendirmektir. Hastalar ve Metod: Çalışmaya 91 stabil KOAH’lı hasta ve 42 kontrol birey alındı. KOAH ağırlığı GOLD (Global Initiative for Chronic Obstructive Lung Disease) kriterlerine göre belirlendi. Metabolik sendrom tanısında ATP III (The National Choleste- rol Education Program’s Adult Treatment Panel III) kriterleri kullanıldı. Hasta ve kontrol grubunda alınan venöz kan örne- ğinde CRP düzeyleri ölçüldü. Bulgular: Metabolik sendrom frekansı hasta grubunda, özellikle GOLD I, II’de, kontrol grubundan daha yüksek bulundu (p= 0.004). Metabolik sendromun abdominal obezite, hipertansiyon ve hiperglisemi komponentlerinin frekansı hasta grubunda daha yüksek bulundu (p< 0.0001). Artmış CRP düzeyleri kontrol grubunda ve hasta grubun tüm evrelerinde, metabolik sendrom olanlarda, olmayanlara göre daha yüksek orandaydı (p= 0.047, p= 0.217, p< 0.001, p= 0.05, p= 0.467). Sonuç: Bu çalışma metabolik sendrom frekansının stabil KOAH’lı hastalarda, kontrol grubundan ve Türk popülasyonun- dan daha yüksek olduğunu göstermiştir. Abdominal obezite, hipertansiyon ve hiperglisemi hasta grubunda anlamlı dere- cede daha sıktı. Sistemik inflamasyon metabolik sendromu olan KOAH’lı hastalarda olmayanlara göre daha yoğundu.