https://doi.org/10.4081/monaldi.2021.2024
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
Accepted: December 20, 2021
Abstract Views: 2504
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
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.
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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