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Mortality associated with metabolic syndrome in people with COPD managed in primary care

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posted on 2023-03-23, 15:02 authored by Urvee Karsanji, Rachael A. Evans, Jennifer K. Quint, Kamlesh Khunti, Claire A. Lawson, Emily PetherickEmily Petherick, Neil J. Greening, Sally J. Singh, Matthew Richardson, Michael C. Steiner

Objective: The prevalence of metabolic syndrome (MetS) has been reported to be higher in selected populations of people with COPD. The impact of MetS on mortality in COPD is unknown. We used routinely collected healthcare data to estimate the prevalence of MetS in people with COPD managed in primary care and determine its impact on 5-year mortality. 

Methods: Records from 103 955 patients with COPD from the Clinical Practice Research Datalink (CPRD-GOLD) between 2009 to 2017 were scrutinised. MetS was defined as the presence of three or more of: obesity, hypertension, lowered high-density lipoprotein cholesterol, elevated triglycerides or type 2 diabetes mellitus (T2DM). Univariate and multivariable Cox regression models were constructed to determine the prognostic impact of MetS on 5-year mortality. Similar univariate models were constructed for individual components of the definition of MetS. 

Results: The prevalence of MetS in the COPD cohort was 10.1%. Univariate analyses showed the presence of MetS increased mortality (hazard ratio (HR) 1.19, 95% CI: 1.12–1.27, p<0.001), but this risk was substantially attenuated in the multivariable analysis (HR 1.06, 95% CI: 0.99–1.13, p=0.085). The presence of hypertension (HR 1.70, 95% CI: 1.63–1.77, p<0.001) and T2DM (HR 1.41, 95% CI: 1.34– 1.48, p<0.001) increased and obesity (HR 0.74, 95% CI: 0.71–0.78, p<0.001) reduced mortality risk. 

Conclusion: MetS in patients with COPD is associated with higher 5-year mortality, but this impact was minimal when adjusted for indices of COPD disease severity and other comorbidities. Individual components of the MetS definition exerted differential impacts on mortality suggesting limitation to the use of MetS as a multicomponent condition in predicting outcome in COPD.

Funding

National Institute for Health Research (NIHR)

History

School

  • Sport, Exercise and Health Sciences

Published in

ERJ Open Research

Volume

8

Issue

4

Publisher

European Respiratory Society

Version

  • VoR (Version of Record)

Rights holder

© The authors

Publisher statement

This is an Open Access Article. It is published by the European Respiratory Society under the Creative Commons Attribution 4.0 International Licence (CC BY). Full details of this licence are available at: https://creativecommons.org/licenses/by/4.0/

Acceptance date

2022-07-14

Publication date

2022-10-24

Copyright date

2022

eISSN

2312-0541

Language

  • en

Depositor

Dr Emily Petherick. Deposit date: 23 March 2023

Article number

00211-2022

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