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CLINICAL AND METABOLIC FEATURES OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN COMBINATION WITH OBESITY

Ovsyannikov E.S., Avdeev S.N. , Natarov A.A., Budnevsky A.V., Shkatova Ya.S.

Background. According to recent studies, the prevalence of obesity in patients with chronic obstructive pulmonary disease (COPD) is up to 50%. Several studies have reported more pronounced respiratory symptoms, a greater frequency of exacerbations, a more pronounced limitation in daily activities in patients with COPD and obesity. However, other studies decribed “obesity paradox” with a favorable prognosis of COPD in obese patients. Objective: to evaluate the features of the disease course, the severity of clinical manifestations, including symptoms, comorbidities and lung function, as well as the characteristics of the cytokine profile in patients with COPD and obesity. Material and methods. The study included 192 patients with COPD (GOLD 2-4, group D). The first group included 96 patients with COPD with normal body weight: 71 men and 25 women, mean age 62.20 ± 8.13 years. The second group - 96 patients with COPD and obesity: 64 men and 24 women, mean age 62.14 ± 5.26 years. In all patients the frequency of COPD exacerbations in the last 12 months and the severity of symptoms were assessed. Spirometry, six-minute walking test were performed. BODE index was counted. The cytokine profile and the level of adipokines were evaluated. Results. Patients with COPD and obesity were characterized by low severity of symptoms (dyspnea, sputum production, weakness) with relatively high values of FEV1, FVC, relatively low risk of COPD exacerbations, and low BODE index, with frequent combination with diabetes, arterial hypertension, the greater severity of systemic inflammation, in particular significant differences in the levels of CRP, interferon-γ, TNF-α, TNF-R1, TNF-R2. Conclusion. It seems appropriate to single out individual phenotypes of COPD with normal body weight and obesity to identify new approaches and strategies to therapy. Key words: chronic obstructive pulmonary disease, obesity, spirometry, interleukins, BODE index.

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