Identifier to cite or link to this item: http://hdl.handle.net/20.500.13003/11094
Non-emphysematous chronic obstructive pulmonary disease is associated with diabetes mellitus
StatisticsItem usage statistics
MetadataShow Dublin Core item record
AuthorHersh, Craig P.; Make, Barry J.; Lynch, David A.; Barr, R. Graham; Bowler, Russell P.; Calverley, Peter M. A.; Castaldi, Peter J.; Cho, Michael H.; Coxson, Harvey O.; DeMeo, Dawn L.; Foreman, Marilyn G.; Han, MeiLan K.; Harshfield, Benjamin J.; Hokanson, John E.; Lutz, Sharon; Ramsdell, Joe W.; Regan, Elizabeth A.; Rennard, Stephen I.; Schroeder, Joyce D.; Sciurba, Frank C.; Steiner, Robert M.; Tal-Singer, Ruth; van Beek, Edwin J. R.; Silverman, Edwin K.; Crapo, James D.; COPDGene & ECLIPSE Investigators
Document typeresearch article
CitationHersh Craig P, 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.
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.
Quality of Life
Severity of Illness Index
Forced Expiratory Volume
índice de gravedad de la enfermedad
tolerancia al ejercicio
volumen espiratorio forzado
calidad de vida