Impact of the spirometric definition on comorbidities in chronic obstructive pulmonary disease
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Impact of the spirometric definition on comorbidities in chronic obstructive pulmonary disease. / Meteran, Howraman; Thomsen, Simon Francis; Miller, Martin R.; Hjelmborg, Jacob; Sigsgaard, Torben; Backer, Vibeke.
I: Respiratory Medicine, Bind 184, 106399, 2021.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › fagfællebedømt
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TY - JOUR
T1 - Impact of the spirometric definition on comorbidities in chronic obstructive pulmonary disease
AU - Meteran, Howraman
AU - Thomsen, Simon Francis
AU - Miller, Martin R.
AU - Hjelmborg, Jacob
AU - Sigsgaard, Torben
AU - Backer, Vibeke
PY - 2021
Y1 - 2021
N2 - Background: Little is known about how the spirometric definition of airway obstruction affects the association between COPD and comorbidities and whether these associations might be due to genetic predisposition.Aim: 1) To examine the impact of the spirometric definition on the associations between COPD and its comorbidities and 2) To examine whether these associations can be explained by shared genetic or environmental factors.Methods: 11,458 twins, aged 40-80 years, from the Danish Twin Registry were recruited who completed a questionnaire on medical history, life style factors and had a clinical examination. COPD was defined by respiratory symptoms (RS) plus airway obstruction according to either GOLD (FR-COPD) or ERS/ATS guidelines (LLN-COPD). Self-reported physician diagnoses were used to identify comorbidities.Results: The mean age of participants was 58.4 years +/- SD 9.7, mean BMI was 26.6 kg/m(2) +/- SD 4.4, 52% were female and the prevalence of LLN2.5-COPD and FR-COPD was 2.5% and 6.3%, respectively. Among eight major comorbidities, multivariate logistic regression showed COPD was only associated with heart failure, whereas RS alone were associated with 6 out of 8 comorbidities after Bonferroni-correction. There was an increased risk of heart failure, ischemic heart disease, depression and pulmonary embolism in twin individuals with RS compared with the co-twin without RS.Conclusions: COPD was only associated with an increased risk of heart failure. Discordant COPD-individuals (FR-COPD+/LLN5-COPD-) were at increased risk of heart failure. Sub-analyses showed that RS, but not airway obstruction were associated with an increased risk of comorbidities.
AB - Background: Little is known about how the spirometric definition of airway obstruction affects the association between COPD and comorbidities and whether these associations might be due to genetic predisposition.Aim: 1) To examine the impact of the spirometric definition on the associations between COPD and its comorbidities and 2) To examine whether these associations can be explained by shared genetic or environmental factors.Methods: 11,458 twins, aged 40-80 years, from the Danish Twin Registry were recruited who completed a questionnaire on medical history, life style factors and had a clinical examination. COPD was defined by respiratory symptoms (RS) plus airway obstruction according to either GOLD (FR-COPD) or ERS/ATS guidelines (LLN-COPD). Self-reported physician diagnoses were used to identify comorbidities.Results: The mean age of participants was 58.4 years +/- SD 9.7, mean BMI was 26.6 kg/m(2) +/- SD 4.4, 52% were female and the prevalence of LLN2.5-COPD and FR-COPD was 2.5% and 6.3%, respectively. Among eight major comorbidities, multivariate logistic regression showed COPD was only associated with heart failure, whereas RS alone were associated with 6 out of 8 comorbidities after Bonferroni-correction. There was an increased risk of heart failure, ischemic heart disease, depression and pulmonary embolism in twin individuals with RS compared with the co-twin without RS.Conclusions: COPD was only associated with an increased risk of heart failure. Discordant COPD-individuals (FR-COPD+/LLN5-COPD-) were at increased risk of heart failure. Sub-analyses showed that RS, but not airway obstruction were associated with an increased risk of comorbidities.
KW - COPD
KW - Comorbidity
KW - Lung function
KW - Respiratory symptoms
KW - Twin studies
KW - LOWER LIMIT
KW - RISK
KW - PREVALENCE
KW - DEPRESSION
KW - HYPERTENSION
KW - EXACERBATION
KW - DIAGNOSIS
KW - EMBOLISM
KW - CRITERIA
U2 - 10.1016/j.rmed.2021.106399
DO - 10.1016/j.rmed.2021.106399
M3 - Journal article
C2 - 34000574
VL - 184
JO - Respiratory Medicine
JF - Respiratory Medicine
SN - 0954-6111
M1 - 106399
ER -
ID: 274527610