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Non-emphysematous chronic obstructive pulmonary disease is associated with diabetes mellitus.

Publication ,  Journal Article
Hersh, CP; Make, BJ; Lynch, DA; Barr, RG; Bowler, RP; Calverley, PMA; Castaldi, PJ; Cho, MH; Coxson, HO; DeMeo, DL; Foreman, MG; Han, MK ...
Published in: BMC Pulm Med
October 24, 2014

BACKGROUND: Chronic obstructive pulmonary disease (COPD) has been classically divided into blue bloaters and pink puffers. The utility of these clinical subtypes is unclear. However, the broader distinction between airway-predominant and emphysema-predominant COPD may be clinically relevant. The objective was to define clinical features of emphysema-predominant and non-emphysematous COPD patients. METHODS: Current and former smokers from the Genetic Epidemiology of COPD Study (COPDGene) had chest computed tomography (CT) scans with quantitative image analysis. Emphysema-predominant COPD was defined by low attenuation area at -950 Hounsfield Units (LAA-950) ≥10%. Non-emphysematous COPD was defined by airflow obstruction with minimal to no emphysema (LAA-950 < 5%). RESULTS: Out of 4197 COPD subjects, 1687 were classified as emphysema-predominant and 1817 as non-emphysematous; 693 had LAA-950 between 5-10% and were not categorized. Subjects with emphysema-predominant COPD were older (65.6 vs 60.6 years, p < 0.0001) with more severe COPD based on airflow obstruction (FEV1 44.5 vs 68.4%, p < 0.0001), greater exercise limitation (6-minute walk distance 1138 vs 1331 ft, p < 0.0001) and reduced quality of life (St. George's Respiratory Questionnaire score 43 vs 31, p < 0.0001). Self-reported diabetes was more frequent in non-emphysematous COPD (OR 2.13, p < 0.001), which was also confirmed using a strict definition of diabetes based on medication use. The association between diabetes and non-emphysematous COPD was replicated in the ECLIPSE study. CONCLUSIONS: Non-emphysematous COPD, defined by airflow obstruction with a paucity of emphysema on chest CT scan, is associated with an increased risk of diabetes. COPD patients without emphysema may warrant closer monitoring for diabetes, hypertension, and hyperlipidemia and vice versa. TRIAL REGISTRATION: Clinicaltrials.gov identifiers: COPDGene NCT00608764, ECLIPSE NCT00292552.

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Published In

BMC Pulm Med

DOI

EISSN

1471-2466

Publication Date

October 24, 2014

Volume

14

Start / End Page

164

Location

England

Related Subject Headings

  • United States
  • Tomography, X-Ray Computed
  • Severity of Illness Index
  • Respiratory System
  • Quality of Life
  • Pulmonary Emphysema
  • Pulmonary Disease, Chronic Obstructive
  • Middle Aged
  • Male
  • Humans
 

Citation

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Hersh, C. P., Make, B. J., Lynch, D. A., Barr, R. G., Bowler, R. P., Calverley, P. M. A., … COPDGene and ECLIPSE Investigators, . (2014). Non-emphysematous chronic obstructive pulmonary disease is associated with diabetes mellitus. BMC Pulm Med, 14, 164. https://doi.org/10.1186/1471-2466-14-164
Hersh, Craig P., Barry J. Make, David A. Lynch, R Graham Barr, Russell P. Bowler, Peter M. A. Calverley, Peter J. Castaldi, et al. “Non-emphysematous chronic obstructive pulmonary disease is associated with diabetes mellitus.BMC Pulm Med 14 (October 24, 2014): 164. https://doi.org/10.1186/1471-2466-14-164.
Hersh CP, Make BJ, Lynch DA, Barr RG, Bowler RP, Calverley PMA, et al. Non-emphysematous chronic obstructive pulmonary disease is associated with diabetes mellitus. BMC Pulm Med. 2014 Oct 24;14:164.
Hersh, Craig P., et al. “Non-emphysematous chronic obstructive pulmonary disease is associated with diabetes mellitus.BMC Pulm Med, vol. 14, Oct. 2014, p. 164. Pubmed, doi:10.1186/1471-2466-14-164.
Hersh CP, Make BJ, Lynch DA, Barr RG, Bowler RP, Calverley PMA, Castaldi PJ, Cho MH, Coxson HO, DeMeo DL, Foreman MG, Han MK, Harshfield BJ, Hokanson JE, Lutz S, Ramsdell JW, Regan EA, Rennard SI, Schroeder JD, Sciurba FC, Steiner RM, Tal-Singer R, van Beek E, Silverman EK, Crapo JD, COPDGene and ECLIPSE Investigators. Non-emphysematous chronic obstructive pulmonary disease is associated with diabetes mellitus. BMC Pulm Med. 2014 Oct 24;14:164.
Journal cover image

Published In

BMC Pulm Med

DOI

EISSN

1471-2466

Publication Date

October 24, 2014

Volume

14

Start / End Page

164

Location

England

Related Subject Headings

  • United States
  • Tomography, X-Ray Computed
  • Severity of Illness Index
  • Respiratory System
  • Quality of Life
  • Pulmonary Emphysema
  • Pulmonary Disease, Chronic Obstructive
  • Middle Aged
  • Male
  • Humans