PREVALENCE AND RISK FACTOR OF DIABETES MELLITUS AND METABOLIC SYNDROME AMONG STABLE CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS AT BACH MAI HOSPITAL

Abstract

Chronic Obstructive Pulmonary Diseases (COPD) is characterized by a completely irreversible obstruction of the expiratory airflow. This interference with ventilation often progresses slowly, as a result of prolonged exposure to toxic substances and gases. Inflammation, imbalance of the system of Proteinase, Anti-Proteinase, free radical attack and lung parenchyma damage lead to to impaired respiratory function1,2. According to the World Health Organization (WHO), chronic obstructive pulmonary disease (COPD) the world’s fourth leading cause of death and disabilitywith about 50 million people infected and 3 million deaths annually. And it is forecast to rank the 3rd place by 20201,3-5.The frequency will be even higher and mortality is predictable in the coming decades 1. Chronic obstructive pulmonary disease is increasing rapidly, especially in countries with underdeveloped economies, including our country. Some epidemiological studies showed that among 12 countries in the Asian Pacific, Vietnam has the highest disease rate with 6.7% of the population 1. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2010 highlighted the role of comorbidities 4. It is a major determinant of the health status, medical cost, and prognosis of patients with COPD. Concomitant diseases, including cardiovascular disease, diabetes, osteoporosis, MS and muscle weakness, are very common in COPD, but their rates vary widely between studies. According to Van Manen et al, the study on 1,145 COPD patients showed that more than 50% of patients had 1 to 2 comorbidities; 15.8% had 3 to 4 comorbidities and 6.8% had more than 56. The association between COPD and comorbidities can be mainly explained by old age, tobacco exposure history (a major risk factor for both COPD and many other chronic diseases), and treatment drug effects (such as corticosteroids, inhaled bronchodilators and systemic lines)7.. Among the comorbidities, we found the prevalence of Metabolic Syndrome (MS) in patients with COPD. According to a study on the Korean population (n = 1215), there were 133 men (11%) newly diagnosed with COPD showed that the common rate of MS was 27.7%; This rate was significantly higher in the COPD group (36.8%) compared with the group that did not have the COPD (26.6%) 8. Another German study of 30 patients with chronic bronchitis and 170 patients with COPD in stages I, II, III, and IV (according to GOLD) found that the incidence of MS was 53%, 50%,37%, 44% (overall rate 47.5%) 9. Diabetes is a common comorbid condition in patients with COPD, which can increase the risk of hospitalization, the number of days in hospital and death possibility in patients death in patients with Chronic obstructive pulmonary disease.10,11. In contrast, systemic glucocorticoid treatment during exacerbations is also an important contributor to blood glucose disturbances and poor glycemic control in diabetic patients. According to a report by Tran Van Ngoc on the mortality risk factors of chronic obstructive pulmonary exacerbation in 2019, mortality was higher in patients with the disease combination than in the group without the combination (12, 3% versus 8.2%), especially in the diabetic group 22.7% (p <0.05) 12. Up to now, in Vietnam, there have been a number of studies on the co-diseases of COPD, but few topics mention metabolic syndrome, and diabetes. Therefore, we implement these topics with two following objectives : 1. To investigate the prevalence and characteristics of diabetes mellitus and metabolic syndrome among stablechronic obstructive pulmonary disease patients based on blood tests. 2. Todescribe some risk factors of diabetes mellitus and metabolic syndrome among stablechronic obstructive pulmonary disease patients.