PECULIARITIES OF COURSE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH UNDERLYING METABOLIC SYNDROME

Background. Chronic obstructive pulmonary disease (COPD) remains a major public health concern. Of importance is the problem of influence of some comorbid pathologies on the course of COPD, in particular, of metabolic syndrome (MS) with the incidence rate in COPD patients varying between 25.6-60.9% throughout the world. It is assumed that systemic inflammation, inflammation of adipose tissue and lack of physical activity are the main mechanisms underlying the connection between COPD and MS. Aim. To study the effect of MS on the clinical course of COPD, parameters of systemic inflammation, life quality of patients. Materials and Methods. The study included 130 patients. Two groups of patients were formed: group 1 included 40 patients with COPD without MS, group 2 included 40 patients with COPD and MS. All the patients underwent spirometry, 6-minute walk test (6MWT), measurement of interleukin (IL)-6, IL-8, tumor necrosis factor-α (TNF-α), leptin, adiponectin levels; patients completed the CAT, CCQ, SGRQ questionnaires. Results. Reliable differences were found in the parameters of cytokine profile in the compared groups: IL-6, IL-8 and TNF-α levels were 1.6, 1.7 and 2.3 times, respectively, higher (p=0.0000) in patients of the 2nd group compared with the 1st group. The levels of adipocytokines reliably differed in the groups: leptin level was 4.1 times higher in the 2nd group (p=0.0001), adiponectin level was 1.9 times higher (p=0.0002). The results of 6MWT were reliably lower in patients with COPD and MS as compared to COPD patients without MS and were 310.16±1.52 and 361.04±3.09 m, respectively (p=0.0002). Spirometric parameters and parameters of the quality of life were also reliably lower in the 2nd group. Conclusion. Metabolic syndrome negatively affects the clinical course of COPD, leads to worsening of bronchial obstruction, increased activity of systemic inflammation, decreased tolerance to physical activity, severe disturbances in the psychosocial adaptation of patients, and to impaired quality of life.