Tuberc Respir Dis.  2007 Dec;63(6):480-485.

Symptom Questionnaire and Laboratory Findings in Subjects with Airflow Limitation: a Nation-wide Survey

• Hwang YI
• Kim YC
• Lee JH
• Kang MJ
• Kim DG
• Kim SO
• Jang TW
• Lee MK
• Ahn Y
• Yoo JH
• Jung KS

Abstract

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation that is not fully reversible. COPD has systemic effects, such as skeletal muscle dysfunction and abnormal weight loss. It also has been suggested that COPD is related to other chronic disease, such as cardiovascular disease, osteoporosis, and anemia. The aim of this study was to evaluate a symptom questionnaire and laboratory findings in subjects with air flow limitation.
METHODS
We evaluated a symptom questionnaire and laboratory findings in subjects with airflow limitation detected by spirometry in conjunction with the Second Korean National Health and Nutrition Examination Survey. A total of 9,243 adults over the age of 18 were recruited. Among the adults, we finally analyzed 2,217 subjects who met the acceptability and repeatability criteria of spirometry, showed normal findings on chest radiography, and were older than 40 years of age.
RESULTS
There were 288 subjects with airflow limitation as determined by spirometry. The frequency of respiratory symptoms such as cough, sputum and wheezing were significantly higher in subjects with airflow limitation (p<0.01). Hemoglobin and hematocrit levels were higher in subjects with airflow limitation (hemoglobin level 13.98 mg/dL vs. 13.62 mg/dL, hematocrit 42.10% vs. 40.89%; p<0.01). The HDL cholesterol level was lower in subjects with airflow limitation (44.95 mg/dL vs. 45.60 mg/dL; p<0.01). There was no significant difference in the total cholesterol, triglyceride, blood urea nitrogen, creatinine, and fasting glucose levels.
CONCLUSION
In subjects with airflow limitation, prevalence of respiratory symptoms was higher than in normal spirometry subjects and the levels of hemoglobin and the hematocrit were higher. The HDL cholesterol level was lower in subjects with airflow limitation.

Keyword

Chronic obstructive pulmonary disease; Airflow limitation; Symptom questionnaire; Laboratory findings; Systemic effect

MeSH Terms

Adult
Anemia
Blood Urea Nitrogen
Cardiovascular Diseases
Cholesterol
Cholesterol, HDL
Chronic Disease
Cough
Creatinine
Fasting
Glucose
Hematocrit
Humans
Muscle, Skeletal
Nutrition Surveys
Osteoporosis
Prevalence
Pulmonary Disease, Chronic Obstructive
Surveys and Questionnaires*
Radiography
Respiratory Sounds
Spirometry
Sputum
Thorax
Triglycerides
Weight Loss
Cholesterol
Cholesterol, HDL
Creatinine
Glucose

Reference

1. National Heart, Lung, and Blood Institute and World Health Organization. Global initiative for chronic obstructive lung disease: global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2006. cited 25 January 2007. Bethesda, MD, USA: National Heart, Lung, and Blood Institute, National Institutes of Health;Available from: http://www.goldcopd.com.

2. Murray CJ, Lopez AD. Evidence-based health policy--lessons from the Global Burden of Disease Study. Science. 1996. 274:740–743.

3. Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease. Lancet. 1997. 349:1436–1442.

4. Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet. 1997. 349:1498–1504.

5. Celli BR, MacNee W. ATS/ERS Task Force. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J. 2004. 23:932–946.

6. Cote C, Zilberberg MD, Mody SH, Dordelly LJ, Celli B. Haemoglobin level and its clinical impact in a cohort of patients with COPD. Eur Respir J. 2007. 29:923–929.

7. Kim DS, Kim YS, Jung KS, Chang JH, Lim CM, Lee JH, et al. Prevalence of chronic obstructive pulmonary disease in Korea: a population-based spirometry survery. Am J Respir Crit Care Med. 2005. 172:842–847.

8. Choi JK, Paek D, Lee JO. Normal predictive values of spirometry for Korean population. Tuberc Respir Dis. 2005. 58:230–242.

9. John M, Hoernig S, Doehner W, Okonko DD, Witt C, Anker SD. Anemia and inflammation in COPD. Chest. 2005. 127:825–829.

10. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001. 285:2486–2497.

11. Pauwels RA, Rabe KF. Burden and clinical features of chronic obstructive pulmonary disease (COPD). Lancet. 2004. 364:613–620.

12. Calverley PM. COPD: early detection and intervention. Chest. 2000. 117:365S–371S.

13. Fabbri LM, Rabe KF. From COPD to chronic systemic inflammatory syndrome? Lancet. 2007. 370:797–799.

14. Sin DD, Man SF. Chronic obstructive pulmonary disease as a risk factor for cardiovascular morbidity and mortality. Proc Am Thorac Soc. 2005. 2:8–11.