Are Systemic Inflammatory Profiles Different in Patients with COPD and Metabolic Syndrome As Compared to Those with COPD Alone?

Background: Metabolic Syndrome (MS) is frequent in patients with COPD, almost 50% of patients with COPD had one or more components of metabolic syndrome (MS). Moreover, it was demonstrated that BMI might be one of the determinants of COPD phenotype. Chronic comorbid diseases affect health outcomes in COPD, in fact, patients with COPD mainly die of non-respiratory disorders such as cardiovascular disease. Inflammation plays a key role in COPD and MS but we do not know the real inflammatory profile of these patients. A better understanding of the origin and consequences of systemic and local inflammation, and of potential therapies, will most likely lead to better care of patients with COPD.

Methods: We compared 64 consecutive, consenting smoker patients with COPD and MS (mean age: 62.7 +/- 0.7 years) with this serum inflammatory profile (hsCRP: 1.9 +/- 0.01 mg/dL, TNF-alpha: 6,4 +/- 0.1 pg/mL, adiponectin: 4.7 +/- 0.01 mg/L) versus 69 COPD smoker patients matched for age (mean age 61.4 +/- 0.4 years) with following serum inflammatory cytokine (CRP: 0.9 +/- 0.01 mg/dL, TNF-alpha: 3.9 pg/mL +/- 0.01, adiponectin: 9.3 +/- 0.01 mg/L). COPD and MS was diagnosed according to the GOLD criteria respectively IFD 2005 criteria. Data were expressed as mean +/- SE (standard error). Comparisons of parameters among the two groups were made by Student unpaired t test. The level of statistical significance was set as p < 0.05.

Results: Serum TNF-alpha and high-sensitivity CRP levels in patients with COPD and MS were significantly higher (p < 0.05) than those of COPD alone. Plasma adiponectin levels in patients with COPD were significantly higher (p < 0.05) than in subjects with COPD and MS.

Conclusions: Patients with COPD and MS have a more exacerbated systemic inflammatory profile and a significantly reduced specific adipose response represented by adiponectin than patients with COPD alone. These results help us to better understand the inflammatory pattern in patients with COPD with metabolic disorders and permit us to sustain the regulatory role of adiponectin in metabolism balance. It is possible that this association between COPD and MS with a specific inflammatory pattern (high serum levels of CRP and TNF-a but with low plasma levels of adiponectin) to explain the high rate of death adjudicated as due to cardiovascular causes.