Journal article
Non-emphysematous chronic obstructive pulmonary disease is associated with diabetes mellitus
BMC pulmonary medicine, Vol.14(1), pp.164-164
10/24/2014
DOI: 10.1186/1471-2466-14-164
PMCID: PMC4216374
PMID: 25341556
Abstract
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.
Details
- Title: Subtitle
- Non-emphysematous chronic obstructive pulmonary disease is associated with diabetes mellitus
- Creators
- Craig P Hersh - Brigham and Women's HospitalBarry J Make - National Jewish HealthDavid A Lynch - National Jewish HealthR Graham Barr - Columbia UniversityRussell P Bowler - National Jewish HealthPeter MA Calverley - Aintree University HospitalPeter J Castaldi - Channing Division of Network Medicine, Boston, USAMichael H Cho - Brigham and Women's HospitalHarvey O Coxson - University of British ColumbiaDawn L DeMeo - Brigham and Women's HospitalMarilyn G Foreman - Morehouse School of MedicineMeiLan K Han - University of Michigan–Ann ArborBenjamin J Harshfield - Channing Division of Network Medicine, Boston, USAJohn E Hokanson - Colorado School of Public HealthSharon Lutz - Colorado School of Public HealthJoe W Ramsdell - University of California, San DiegoElizabeth A Regan - National Jewish HealthStephen I Rennard - University of Nebraska Medical CenterJoyce D Schroeder - National Jewish HealthFrank C Sciurba - University of PittsburghRobert M Steiner - Temple UniversityRuth Tal-Singer - GlaxoSmithKline (United States)Edwin JR van Beek - University of EdinburghEdwin K Silverman - Brigham and Women's HospitalJames D Crapo - National Jewish HealthCOPDGene & ECLIPSE Investigators
- Contributors
- Eric Hoffman (Contributor) - University of Iowa, Radiology
- Resource Type
- Journal article
- Publication Details
- BMC pulmonary medicine, Vol.14(1), pp.164-164
- DOI
- 10.1186/1471-2466-14-164
- PMID
- 25341556
- PMCID
- PMC4216374
- NLM abbreviation
- BMC Pulm Med
- ISSN
- 1471-2466
- eISSN
- 1471-2466
- Publisher
- BioMed Central
- Language
- English
- Date published
- 10/24/2014
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
- Record Identifier
- 9984318792002771
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