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. 2017 Oct 24;12(10):e0186708.
doi: 10.1371/journal.pone.0186708. eCollection 2017.

Metabolic syndrome and Chronic Obstructive Pulmonary Disease (COPD): The interplay among smoking, insulin resistance and vitamin D

Giuseppina Piazzolla  1 , Anna Castrovilli  1 , Vito Liotino  2 , Maria Rosaria Vulpi  2 , Margherita Fanelli  1 , Antonio Mazzocca  1 , Mafalda Candigliota  1 , Elsa Berardi  1 , Onofrio Resta  2 , Carlo Sabbà  1 , Cosimo Tortorella  1
Affiliations

Metabolic syndrome and Chronic Obstructive Pulmonary Disease (COPD): The interplay among smoking, insulin resistance and vitamin D

Giuseppina Piazzolla et al. PLoS One. .

Abstract

Background: A close relationship between Metabolic Syndrome (MetS) and Chronic Obstructive Pulmonary Disease (COPD) has been described, but the exact nature of this link remains unclear. Current epidemiological data refer exclusively to the MetS prevalence among patients with COPD and data about the prevalence of COPD in MetS patients are still unavailable.

Aim of the study: To analyse and compare risk factors, clinical and metabolic characteristics, as well as the main respiratory function parameters, among patients affected by MetS, COPD or both diseases.

Patients: We recruited 59 outpatients with MetS and 76 outpatients with COPD. After medical history collection, physical examination, blood sampling for routine analysis, spirometric evaluation, they were subdivided into MetS (n = 46), MetS+COPD (n = 60), COPD (n = 29).

Results: A MetS diagnosis was assigned to 62% of COPD patients recruited in the COPD Outpatients Clinic of the Pneumology Department, while the COPD prevalence in MetS patients enrolled in the Internal Medicine Metabolic Disorders Outpatients Clinic was 22%. More than 60% of subjects enrolled in each Department were unaware that they suffered from an additional disease. MetS+COPD patients exhibited significantly higher C-peptide levels. We also found a positive relation between C-peptide and pack-years in all subjects and a negative correlation between C-peptide and vitamin D only in current smokers. Finally, a negative association emerged between smoking and vitamin D.

Conclusions: We have estimated, for the first time, the COPD prevalence in MetS and suggest a potential role of smoking in inducing insulin resistance. Moreover, a direct effect of smoking on vitamin D levels is proposed as a novel mechanism, which may account for both insulin resistance and COPD development.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. MetS and COPD prevalence in outpatients attending the Pneumology or Internal Medicine Departments.
Fig 2
Fig 2. Effect of smoking on serum levels of C-peptide.
Smoking is expressed in terms of number (n) of pack-years. Each symbol identifies a single individual.
Fig 3
Fig 3. Correlation between serum levels of Vitamin D and C-peptide.
Each symbol identifies a single individual.
Fig 4
Fig 4. Effect of smoking on serum levels of Vitamin D.
Smoking is expressed in terms of number (n) of pack-years. Each symbol identifies a single individual.
See this image and copyright information in PMC

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