Role of interleukin-6 and insulin resistance as screening markers for metabolic syndrome in patients of chronic obstructive pulmonary disease. A hospital-based cross-sectional study

Submitted: July 21, 2021
Accepted: December 20, 2021
Published: December 28, 2021
Abstract Views: 2534
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Chronic obstructive pulmonary disease (COPD) is usually associated with a variety of extra-pulmonary manifestations. Metabolic syndrome (MetS) is one such entity that has been scarcely studied in Indian patients. Availability of a good screening marker may help in timely detection of this co morbidity in COPD patients. We conducted a cross sectional study to evaluate the prevalence of MetS among COPD patients and to evaluate the role of Interleukin-6 and insulin resistance (as measured by HOMA-IR) as screening markers for MetS in COPD. A total of 100 stable COPD patients were evaluated for MetS using US National Cholesterol Education Program Adult Treatment Panel III (2005) guidelines. Interleukin-6 and HOMA-IR (for insulin resistance) were measured and compared between COPD patients with and without MetS. ROC analysis was done to find the best cut-off value and sensitivity and specificity of both the molecules in detecting MetS. In the results, the mean age of the study cohort was 59.9+8.7yrs (males=93). Forty five COPD patients (45%) fulfilled the criteria for MetS. Patients with MetS were comparatively younger (57.9+9.5 v/s 61.6+7.8 years; p=0.037) but had longer duration of preceding COPD (9.9+2.8 v/s 6.0+2.2 years; p<0.001) as compared to those without MetS. Both IL-6 and HOMA index were statistically higher (p<0.05) in COPD–MetS patients as compared to the other group. At cutoff value of 36.3 pg/ml for IL-6 and 1.61 for HOMA index, IL-6 and HOMA-IR had sensitivity 91.1% and 82.2% respectively in detecting MetS among COPD patients. To conclude, metabolic syndrome is a common comorbidity seen in COPD patients. Interleukin-6 has a better sensitivity than HOMA-IR in screening MetS among COPD patients. 

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McKay AJ, Mahesh PA, Fordham JZ, Majeed A. Prevalence of COPD in India: a systematic review. Prim Care Respir J 2012;21:313-21. DOI: https://doi.org/10.4104/pcrj.2012.00055
World Health Organization. The top 10 causes of death. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
Mannino DM, Thorn D, Swensen A, Holguin F. Prevalence and outcomes of diabetes, hypertension and cardiovascular disease in COPD. Eur Respir J 2008;32:962-9. DOI: https://doi.org/10.1183/09031936.00012408
Cebron Lipovec N, Beijers RJ, van den Borst B, et al. The prevalence of metabolic syndrome in chronic obstructive pulmonary disease: A systematic review. COPD 2016;13:399-406. DOI: https://doi.org/10.3109/15412555.2016.1140732
Sridharan VSHK, Acharya V. Comorbidities of chronic obstructive pulmonary disease and their effect on hospitalization of patients in a tertiary care hospital. J Community Hosp Intern Med Perspect 2021;11:120-23 DOI: https://doi.org/10.1080/20009666.2020.1843823
Breyer MK, Spruit MA, Hanson CK, et al. Prevalence of metabolic syndrome in COPD patients and its consequences. PloS One 2014;9:e98013. DOI: https://doi.org/10.1371/journal.pone.0098013
Rubinsztajn R, Przybylowski T, Maskey-Warzechowska M, et al. Metabolic syndrome as a factor affecting systemic inflammation in patients with chronic obstructive pulmonary disease. Adv Exp Med Biol 2017;1021 55-62. DOI: https://doi.org/10.1007/5584_2017_28
Singh NK, Karki L. Metabolic syndrome in patients with chronic obstructive pulmonary disease in medicine department of a tertiary care hospital: A descriptive cross-sectional study. JNMA J Nepal Med Assoc 2021;59:313-16. DOI: https://doi.org/10.31729/jnma.6410
Kiani FZ, Ahmadi A. Prevalence of different comorbidities in chronic obstructive pulmonary disease among Shahrekord PERSIAN cohort study in southwest Iran. Sci Rep 2021;11:1548. DOI: https://doi.org/10.1038/s41598-020-79707-y
Priyadharshini N, Renusha RC, Reshma S, et al. Prevalence of metabolic syndrome in patients with chronic obstructive pulmonary disease: An observational study in South Indians. Diabetes Metab Syndr 2020;14:503-7. DOI: https://doi.org/10.1016/j.dsx.2020.04.042
Agusti A, Soriano JB. COPD as a systemic disease. COPD 2008 5:133-8. DOI: https://doi.org/10.1080/15412550801941349
Barnes PJ, Celli BR. Systemic manifestations and comorbidities of COPD. Eur Respir J 2009;33:1165-85. DOI: https://doi.org/10.1183/09031936.00128008
Hosny H, Abdel-Hafiz H, Moussa H, Soliman A. Metabolic syndrome and systemic inflammation in patients with chronic obstructive pulmonary disease. Egypt J Chest Dis Tuberc 2013;62:85-9. DOI: https://doi.org/10.1016/j.ejcdt.2013.02.007
Garcia-Rio F, Miravitlles M, Soriano JB, et al. Systemic inflammation in chronic obstructive pulmonary disease: a population-based study. Respir Res 2010;11:63. DOI: https://doi.org/10.1186/1465-9921-11-63
Wei J, Xiong XF, Lin YH, et al. Association between serum interleukin-6 concentrations and chronic obstructive pulmonary disease: a systematic review and meta-analysis. Peer J 2015;3:e1199. DOI: https://doi.org/10.7717/peerj.1199
Kiran Z, Majeed N, Zuberi BF. Comparison of frequency of insulin resistance in patients with chronic obstructive pulmonary disease with normal controls. Pak J Med Sci 2015;31:1506-10. DOI: https://doi.org/10.12669/pjms.316.7983
Eker S, Ayaz L, Tamer L, Ulubas B. Leptin, visfatin, insulin resistance, and body composition change in chronic obstructive pulmonary disease. Scand J Clin Lab Invest 2010;70:40-4. DOI: https://doi.org/10.3109/00365510903484063
Bolton CE, Evans M, Ionescu AA, et al. Insulin resistance and inflammation - A further systemic complication of COPD. COPD 2007;4:121-6. DOI: https://doi.org/10.1080/15412550701341053
Khan Y, Lalchandani A, Gupta AC, et al. Prevalence of metabolic syndrome crossing 40% in Northern India: Time to act fast before it runs out of proportions. J Family Med Prim Care 2018;7:118-23. DOI: https://doi.org/10.4103/jfmpc.jfmpc_10_17
Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management and prevention of COPD (updated 2016). Accessed: Oct 2, 2016. Available from: https://goldcoped.org/
Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J 2005;26:319-38. DOI: https://doi.org/10.1183/09031936.05.00034805
Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement: Executive Summary. Crit Pathw Cardiol 2005;4:198-203. DOI: https://doi.org/10.1161/CIRCULATIONAHA.105.169405
Choi HS, Rhee CK, Park YB, et al. Metabolic syndrome in early chronic obstructive pulmonary disease: Gender differences and impact on exacerbation and medical costs. Int J Chron Obstruct Pulmon Dis 2019;14:2873-83. DOI: https://doi.org/10.2147/COPD.S228497
Minas M, Kostikas K, Papaioannou AI, et al. The association of metabolic syndrome with adipose tissue hormones and insulin resistance in patients with COPD without co-morbidities. COPD 2011;8:414-20. DOI: https://doi.org/10.3109/15412555.2011.619600
Koul PA. Metabolic syndrome and chronic obstructive pulmonary disease. Lung India 2016;33:359-61. DOI: https://doi.org/10.4103/0970-2113.184865
Piazzolla G, Castrovilli A, Liotino V, et al. Metabolic syndrome and chronic obstructive pulmonary disease (COPD): The interplay among smoking, insulin resistance and vitamin D. PloS One 2017;12 e0186708. DOI: https://doi.org/10.1371/journal.pone.0186708
Watz H, Waschki B, Kirsten A, et al. The metabolic syndrome in patients with chronic bronchitis and COPD: frequency and associated consequences for systemic inflammation and physical inactivity. Chest 2009;136:1039-46. DOI: https://doi.org/10.1378/chest.09-0393
Geslain-Biquez C, Vol S, Tichet J, et al. The metabolic syndrome in smokers. The D.E.S.I.R. study. Diabetes Metab 2003;29:226-34. DOI: https://doi.org/10.1016/S1262-3636(07)70031-9
Elliott JM, Simpson FO. Cigarettes and accelerated hypertension. N Z Med J 1980;91:447-9.
Rimm EB, Chan J, Stampfer MJ, Colditz GA, Willett WC. Prospective study of cigarette smoking, alcohol use, and the risk of diabetes in men. BMJ 1995;310:555-9. DOI: https://doi.org/10.1136/bmj.310.6979.555
Gan WQ, Man SF, Senthilselvan A, Sin DD. Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis. Thorax 2004;59:574-80. DOI: https://doi.org/10.1136/thx.2003.019588
Ropcke S, Holz O, Lauer G, et al. Repeatability of and relationship between potential COPD biomarkers in bronchoalveolar lavage, bronchial biopsies, serum, and induced sputum. PloS One 2012;7:e46207. DOI: https://doi.org/10.1371/journal.pone.0046207
Naik D, Joshi A, Paul TV, Thomas N. Chronic obstructive pulmonary disease and the metabolic syndrome: Consequences of a dual threat. Indian J Endocrinol Metab 2014;18:608-16.
Kishimoto T. Interleukin-6: from basic science to medicine--40 years in immunology. Annu Rev Immunol 2005;23:1-21. DOI: https://doi.org/10.1146/annurev.immunol.23.021704.115806
Walter RE, Wilk JB, Larson MG, et al. Systemic inflammation and COPD: the Framingham heart study. Chest 2008;133:19-25. DOI: https://doi.org/10.1378/chest.07-0058
Diez-Manglano J, Barquero-Romero J, Almagro P, et al. COPD patients with and without metabolic syndrome: clinical and functional differences. Intern Emerg Med 2014;9:419-25. DOI: https://doi.org/10.1007/s11739-013-0945-7

How to Cite

Dogra, Manu, Surabhi Jaggi, Deepak Aggarwal, Seema Gupta, Varinder Saini, and Jasbinder Kaur. 2021. “Role of Interleukin-6 and Insulin Resistance As Screening Markers for Metabolic Syndrome in Patients of Chronic Obstructive Pulmonary Disease. A Hospital-Based Cross-Sectional Study”. Monaldi Archives for Chest Disease 92 (3). https://doi.org/10.4081/monaldi.2021.2024.

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