Abstract
Background: Metabolic risk factors increase morbidity and mortality in COPD patients. The influence of pulmonary rehabilitation on these parameters is not well studied.
Aim: To study the prevalence of metabolic syndrome, its' selected components and sarcopenia in patients with advanced COPD and the response of MetS components to short-term high-intensity rehabilitation.
Methods: Blood biomarkers were assessed in patients at baseline and after 4-week short–term high-intensity rehabilitation. Metabolic syndrome (MetS) was defined using the International Diabetes Federation criteria. Sarcopenia was assessed at start of the program (skeletal muscle index <7.23 kg/m2 for men and <5.67 kg/m2 for women by dual-energy X-ray absorptiometry).
Results: We included 109 stable COPD patients (66±8 years, 85% GOLD III/IV, 64% men). MetS and sarcopenia were detected in 48% and 53% of patients, respectively. Sarcopenia was lower, but still highly prevalent in patients with MetS (41% vs. 62%, p=0.05). Hypertension, increased waist circumference (WC), increased fasting glucose (FG), hypertriglyceridemia and low HDL cholesterol (HDL-c) were present in 85%, 71%, 68%, 12% and 9% patients, respectively. After rehabilitation, a decrease in WC (104.1 to 101.1 cm, p<0.01) and FG (6.9 to 6.3 mmol/l, p=0.07) was seen in MetS patients. A decrease in lipid levels was observed in the whole group, including a significant decrease in HDL-c (1.72 to 1.47 mmol/l, p<0.01).
Conclusions: About half of patients with advanced COPD have metabolic syndrome or sarcopenia. Rehabilitation reduces the metabolic risk profile.
- Copyright ©ERS 2015