Comprehensive Assessment of Cardiometabolic Risk in Patients with Chronic Obstructive Pulmonary Disease and Obesity

Abstract

Background: Currently, comorbid patients with chronic obstructive pulmonary disease (COPD) and obesity are becoming increasingly common in clinical practice. The objective of this study was to conduct a comparative analysis of indicators of various types of body metabolism (carbohydrate, lipid, adipokine profile) in COPD patients with obesity and normal body weight. Methods and Results: The study included 86 patients with COPD (GOLD 3-4, group D). The diagnosis of COPD was established in accordance with GOLD, revision 2021.The patients were divided into two groups. Group 1 consisted of 43 COPD patients with NBW [31(72.7%) men and 12(27.3%) women aged 43 to 75 years (mean age of 62.40 ± 8.83 years)] and Group 2 consisted of 43 COPD patients with obesity [32(77.27%) men and 11(22.73%) women aged 48 to 72 years (mean age of 62.94 ± 5.96 years)]. All patients underwent an analysis of the composition of the body by the bioelectrical impedance method. Blood levels of total cholesterol (TC), triglycerides (TG), HDL-C, and LDL-C were determined by the enzymatic colorimetric method. The glucose level was determined by the glucose oxidant method. The serum adipokine levels (leptin, adiponectin, resistin), as well as testosterone and immunoreactive insulin, were determined using ELISA. To assess insulin resistance, the HOMA-IR index was calculated. To determine cardiovascular risk, the visceral adiposity index (VAI) was calculated according to the formula, which considers body mass index, triglycerides, HDL-C, and waist circumference. The level of HDL-C was significantly lower (P=0.0000)), and the levels of TC (P=0.0479), LDL-C (P=0.0020), glucose (P=0.0020), immunoreactive insulin (P=0.0000), and HOMA-IR index (P=0.0000), were significantly higher in Group 2 than in Group 1. As for the content of adipose tissue hormones, the leptin level was significantly higher in Group 2 (P=0.0000) than in Group 1, while there were no statistically significant differences between groups in the level of resistin (P=0.4996). The adiponectin level was significantly lower in Group 2 than in Group 1 (P<0.0001). The VAI level in Group 2 was significantly higher than in Group 1 (2.13±1.56 and 1.18±0.41, respectively, P=0.0002). In contrast, the testosterone level was significantly lower in Group 2 than in Group 1 (10.59±6.94 nmol/l and 20.02±12.25 nmol/l, respectively, P=0.0000). Conclusion: The high metabolic activity of adipose tissue in patients with COPD and obesity is directly related to the progression of comorbid conditions.