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Impact of overlap syndrome on severity of acute exacerbation of chronic obstructive pulmonary disease.

Gothi D, Gupta SS, Kumar N, Sood K - Lung India (2015 Nov-Dec)

Bottom Line: Of 51 patients, 13 had OSAS i.e. the prevalence of overlap in AECOPD was 25.5%.AECOPD have a high prevalence of OSAS.Overlap syndrome have significantly higher likelihood of obesity and metabolic syndrome compared to only COPD.

View Article: PubMed Central - PubMed

Affiliation: Department of Pulmonary Medicine, ESI-Post Graduate Institute of Medical Sciences and Research, Delhi, India.

ABSTRACT

Background: The severity of exacerbation in chronic obstructive pulmonary disease (COPD) due to the overlap of obstructive sleep apnea syndrome (OSAS) is not known.

Aims: To find out the 1) severity of acute exacerbation of COPD (AECOPD) in patients with overlap syndrome compared to only COPD, 2) prevalence of overlap syndrome in AECOPD, and 3) clinical characteristics of COPD compared to overlap syndrome.

Materials and methods: Fifty-one patients admitted with AECOPD were classified into; Mild exacerbation: Normal arterial blood gases (ABG) treated with antibiotics, Moderate: Normal ABG treated with parenteral corticosteroids, Severe: Type 1 respiratory failure, Very severe: Type 2 respiratory failure with normal pH and Life-threatening: Type 2 respiratory failure with pH <7.35. They were evaluated for OSAS with full polysomnography after the exacerbation subsided and analysed depending on presence or absence of overlap syndrome.

Results: The majority of only COPD cases (26/38) had mild and moderate exacerbations whereas majority of overlap patients (9/13) had severe, very severe and life-threatening exacerbations (statistically significant, P = 0.021). Of 51 patients, 13 had OSAS i.e. the prevalence of overlap in AECOPD was 25.5%. The mean BMI in only COPD and overlap syndrome was 20.70 ± 8.03 kg/m(2) and 31.82 ± 5.80 kg/m(2) (P < 0.001), respectively. Metabolic syndrome was recorded in 2/36 (5.3%) patients in only COPD and 6/13 (46.2%) patients in overlap (P < 0.001).

Conclusion: Overlap syndromes are more likely have respiratory failure compared to only COPD during AECOPD. AECOPD have a high prevalence of OSAS. Overlap syndrome have significantly higher likelihood of obesity and metabolic syndrome compared to only COPD.

No MeSH data available.


Related in: MedlinePlus

Distribution of cases in two groups according to blood sugar and lipid parametersGroup I = Only COPD, Group II = Overlap
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Figure 4: Distribution of cases in two groups according to blood sugar and lipid parametersGroup I = Only COPD, Group II = Overlap

Mentions: The comparison of patients in two groups according to the blood sugar and lipid parameters has been shown in Table 2 and Chart 4. As compared to only COPD, the mean fasting blood sugar, serum cholesterol and low density lipoprotein (LDL) levels were significantly high in overlap (P < 0.001). Serum very low-density lipoprotein (VLDL) level was also higher in overlap as compared to only COPD but the difference was not significant statistically (P > 0.05). Four out of thirty-eight patients (10.5%) in only COPD and 13/13 patients (100%) in overlap were detected to have hypertension. The association was statistically significant (P < 0.001) i.e. χ2 = 34.895 (df = 1). Overall the metabolic syndrome was observed in only two out of thirty-six (5.3%) patients in only COPD and 6/13 (46.2%) patients in overlap. The difference between the two group was χ2 = 12.246 (df = 1) i.e. statistically significant (P < 0.001). Multiple regression analysis to show that obesity, OSAS or combined effect of both was responsible for the presence of metabolic syndrome could not be done due to a small number of patients with overlap syndrome and obesity.


Impact of overlap syndrome on severity of acute exacerbation of chronic obstructive pulmonary disease.

Gothi D, Gupta SS, Kumar N, Sood K - Lung India (2015 Nov-Dec)

Distribution of cases in two groups according to blood sugar and lipid parametersGroup I = Only COPD, Group II = Overlap
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663860&req=5

Figure 4: Distribution of cases in two groups according to blood sugar and lipid parametersGroup I = Only COPD, Group II = Overlap
Mentions: The comparison of patients in two groups according to the blood sugar and lipid parameters has been shown in Table 2 and Chart 4. As compared to only COPD, the mean fasting blood sugar, serum cholesterol and low density lipoprotein (LDL) levels were significantly high in overlap (P < 0.001). Serum very low-density lipoprotein (VLDL) level was also higher in overlap as compared to only COPD but the difference was not significant statistically (P > 0.05). Four out of thirty-eight patients (10.5%) in only COPD and 13/13 patients (100%) in overlap were detected to have hypertension. The association was statistically significant (P < 0.001) i.e. χ2 = 34.895 (df = 1). Overall the metabolic syndrome was observed in only two out of thirty-six (5.3%) patients in only COPD and 6/13 (46.2%) patients in overlap. The difference between the two group was χ2 = 12.246 (df = 1) i.e. statistically significant (P < 0.001). Multiple regression analysis to show that obesity, OSAS or combined effect of both was responsible for the presence of metabolic syndrome could not be done due to a small number of patients with overlap syndrome and obesity.

Bottom Line: Of 51 patients, 13 had OSAS i.e. the prevalence of overlap in AECOPD was 25.5%.AECOPD have a high prevalence of OSAS.Overlap syndrome have significantly higher likelihood of obesity and metabolic syndrome compared to only COPD.

View Article: PubMed Central - PubMed

Affiliation: Department of Pulmonary Medicine, ESI-Post Graduate Institute of Medical Sciences and Research, Delhi, India.

ABSTRACT

Background: The severity of exacerbation in chronic obstructive pulmonary disease (COPD) due to the overlap of obstructive sleep apnea syndrome (OSAS) is not known.

Aims: To find out the 1) severity of acute exacerbation of COPD (AECOPD) in patients with overlap syndrome compared to only COPD, 2) prevalence of overlap syndrome in AECOPD, and 3) clinical characteristics of COPD compared to overlap syndrome.

Materials and methods: Fifty-one patients admitted with AECOPD were classified into; Mild exacerbation: Normal arterial blood gases (ABG) treated with antibiotics, Moderate: Normal ABG treated with parenteral corticosteroids, Severe: Type 1 respiratory failure, Very severe: Type 2 respiratory failure with normal pH and Life-threatening: Type 2 respiratory failure with pH <7.35. They were evaluated for OSAS with full polysomnography after the exacerbation subsided and analysed depending on presence or absence of overlap syndrome.

Results: The majority of only COPD cases (26/38) had mild and moderate exacerbations whereas majority of overlap patients (9/13) had severe, very severe and life-threatening exacerbations (statistically significant, P = 0.021). Of 51 patients, 13 had OSAS i.e. the prevalence of overlap in AECOPD was 25.5%. The mean BMI in only COPD and overlap syndrome was 20.70 ± 8.03 kg/m(2) and 31.82 ± 5.80 kg/m(2) (P < 0.001), respectively. Metabolic syndrome was recorded in 2/36 (5.3%) patients in only COPD and 6/13 (46.2%) patients in overlap (P < 0.001).

Conclusion: Overlap syndromes are more likely have respiratory failure compared to only COPD during AECOPD. AECOPD have a high prevalence of OSAS. Overlap syndrome have significantly higher likelihood of obesity and metabolic syndrome compared to only COPD.

No MeSH data available.


Related in: MedlinePlus