Severe Metabolic Syndrome linked to severe decline in pulmonary functions

All metabolic syndrome (MetS) components were associated with pulmonary function impairment, reports a study published in the Journal of The Association of Physicians of India. The study suggests that patients have a more severe decline in pulmonary function as the number of MetS components increases.

Metabolic Syndrome (MetS) is defined as a constellation of an interconnected physiological, biochemical, clinical, and metabolic factors that directly increases the risk of atherosclerotic cardiovascular disease and Type 2 Diabetes Mellitus.

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A cross-sectional prevalence study was done in tertiary care hospital in northern India on 100 patients aged between 25-65 years who fulfilled the criteria for Metabolic Syndrome to evaluate pulmonary function test (Spirometry) abnormalities. Patients with the cardiac, endocrine, pulmonary, orthopedic, or neurogenic condition and any systemic or surgical illness were excluded from the study.

A total of 100 patients of Met-S fulfilling the inclusion criteria of the study were enrolled as cases and classified as group I while 100 age gender-matched controls (normal healthy subjects) were also included in the study and classified as group II.

Key study findings:

• On comparing the hematological and biochemical variables, a statistically significant difference among patients of group I and group II was observed in SGPT, serum ALP levels, and serum albumin levels only.


• SGPT level of subjects of group II was found to be significantly higher than that of group I.


• In the same way ALP level of subjects of group I was found to be significantly higher than that of group II.


• The mean serum albumin levels of group II were found to be significantly higher than that of group I.


• Among group I, the proportion of subjects with obesity, hypertension, raised fasting blood sugar level, increased triglyceride level, and low HDL level was 100%, 79%, 100%, 88%, 48% respectively.


• In the same way, among group II proportion of subjects with obesity, hypertension, raised fasting blood sugar level, increased triglyceride level, and low HDL level were 21%, 9%, 1%, 1, 0% respectively.


• The difference between different variables of MetS between the two groups was found to be statistically significant.

Metabolic Syndrome and pulmonary function test

• The subjects with MetS showed significantly lower FVC % predicted, FEV1% predicted, and significantly higher FEV1/FVC % predicted ratio as compared to control.


• On comparing the FEV1 of group I subjects, a continuous decline in FEV1 with an increase in the number of metabolic syndrome components was observed and this association was found to be statistically significant.


• On comparing the FVC of these subjects, a continuous decline in FVC with an increase in the number of Metabolic Syndrome components was observed and this association was found to be statistically significant.


• In the same way on comparing the FEV1/ FVC of these subjects, a continuous decline in FEV1/FVC with an increase of the number of metabolic syndrome components was observed and this association was found to be statistically significant.


• Prevalence of normal ventilatory patterns in the study group among male was 50% and the restrictive pattern was 28% followed by a mixed pattern (7%). In the same way prevalence of normal ventilatory pattern among female was 40% followed by restrictive pattern 46.6% and mixed pattern (13.4%).

The study concluded that the pulmonary function variables are significantly decreased in a subject with Metabolic Syndrome compared to non-metabolic subjects.

"Our study proposed that 53% of the MetS patients had spirometry abnormality in the form of Restrictive (42%), and mixed pattern (11%). None of the patients had the obstructive pattern. Change in FEV1, FVC was inversely proportional to each component of MetS, and also there was a strong linear decrease in FVC percent predicted, FEV1 percentage predicted as the number of components of Metabolic Syndrome increases", write the authors.

For reference log on to http://www.japi.org/october_2018/oa-4.html