Are metabolic syndrome and its components associated with 5-year mortality in chronic obstructive pupmonary disease patients?

The aim of this study was to evaluate the risk of mortality according to the presence of metabolic syndrome in chronic obstructive pulmonary disease (COPD) patients who were followed for 5 years. We did not establish the influence of metabolic syndrome on mortality rate. However, an increase of 100 mg of triglycerides was associated with a 39% increase in the probability of death in the period of the study (hazard ratio 1.39, 95% confidence interval 1.06-1.83)

Influência de características gerais na qualidade de vida de pacientes com doença pulmonar obstrutiva crônica Influence of general clinical parameters on the quality of life of chronic obstructive pulmonary disease patients

INTRODUÇÃO: Não há consenso a respeito dos fatores que influenciam a qualidade de vida nos portadores de doença pulmonar obstrutiva crônica (DPOC). Entretanto, a sua determinação pode nortear abordagens que visem à melhora da qualidade de vida desses pacientes. OBJETIVO: Avaliar fatores que podem interferir na qualidade de vida de pacientes com DPOC selecionados para reabilitação pulmonar. MÉTODO: Foram avaliados vinte e um pacientes com doença pulmonar obstrutiva crônica moderada a grave. Pressão inspiratória máxima (PImax), teste de caminhada de seis minutos (TC6), composição corpórea, função pulmonar, gases sangüíneos, dinamometria de membros superiores, força muscular de quadríceps e questionário de qualidade de vida do Hospital Saint George (SGRQ) foram estudados. RESULTADOS: Foram observadas correlações negativas estatisticamente significativas entre as seguintes variáveis: escore do domínio "Impacto" com o volume expiratório forçado no primeiro segundo (VEF1) (r = -0,68; p = 0,004), relação entre VEF1 e capacidade vital forçada (VEF1/CVF) (r = -0,61; p = 0,014), pico de fluxo expiratório (PFE) (r = -0,53; p = 0,015), TC6 (r = -0,63; p = 0,001) e índice de massa corpórea (IMC) (r = -0,64; p = 0,002); escore do domínio "Atividades" com PImax (r = -0,57; p = 0,007), saturação de O2 (SpO2) (r = -0,52; p = 0,018) e TC6 (r = -0,58; p = 0,007); escore do domínio "Sintomas" com IMC (r = -0,60; p = 0,005); e escore "Total" com VEF1 (r = -0,64; p = 0,01), PFE (r = -0,47; p = 0,033) e IMC (r = -0,57; p = 0,009). A regressão múltipla linear indicou como principais variáveis independentes o IMC, com influência significativa nos domínios sintomas (p = 0,002), impacto (p = 0,009) e no escore total (p = 0,024), e o TC6, com influência significativa nos domínios atividades (p = 0,048) e impacto (p = 0,010). CONCLUSÕES: O IMC e o TC6 tiveram influência nos índices de qualidade de vida. Portanto, estas variáveis devem ser consideradas nas estratégias para melhorar a qualidade de vida de pacientes com doença pulmonar obstrutiva crônica.<br>BACKGROUND: There is currently no consensus regarding which factors influence the quality of life of patients suffering from chronic obstructive pulmonary disease (COPD). However, identifying such factors could orient approaches to improving the quality of the lives of these patients. OBJECTIVE: To evaluate factors that can interfere with quality of life in COPD patients selected for pulmonary rehabilitation. METHODS: Twenty-one patients with moderate to severe COPD were evaluated. Maximal inspiratory pressure (MIP), 6-minute walk test (6MWT), body mass index (BMI), pulmonary function, blood gases, grip strength (measured with a dynamometer), quadriceps strength and St. George's Respiratory Questionnaire (SGRQ) scores were assessed. RESULTS: Statistically significant negative correlations with quality of life were found for the following factors: "impact" scores of: forced expiratory volume in one second (FEV1) (r = -0.68; p = 0.004), FEV1 to forced vital capacity ratio (FEV1/FVC) (r = -0.61; p = 0.014), peak expiratory flow (PEF) (r = -0.53 (p = 0.015), 6MWT (r = -0.63; p = 0.001) and BMI (r = -0.64; p = 0.002); "activity" scores for: MIP (r = -0.57; p = 0.007), baseline arterial oxygen saturation by pulse oximetry (SpO2) (r = -0.52; p = 0.018) and 6MWT (r = -0.58; p = 0.007); "symptom" score for: BMI (r = -0.60; p = 0.005); and "total" scores for: FEV1 (r = -0.64; p = 0.01), PEF (r = -0.47; p = 0.033) and BMI (r = -0.57; p = 0.009). Multiple linear regression revealed the primary factors influencing quality of life to be: BMI, which presented a significant influence on "symptom", "impact" and "total" scores (p = 0.002, p = 0.009 and p = 0.024, respectively); and 6MWT, which had a significant influence on "activity" and "impact" scores (p = 0.048 and p = 0.010, respectively). CONCLUSIONS: The BMI and 6MWT were shown to have an influence on quality of life in the COPD patients studied. Therefore, therapeutic approaches to improving the quality of life of COPD patients should take these indices into consideration