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17. Six-minute walk test in non-insulin-dependent diabetes mellitus patients living in Northwest Africa

Author

Latiri I, Elbey R, Hcini K, Zaoui A, Charfeddine B, Maarouf MR, Tabka Z, Zbidi A, and Ben Saad H

Subjects
Specialties of internal medicine, RC581-951
Abstract

Imed Latiri,1 Rihab Elbey,1 Kamel Hcini,1 Afif Zaoui,2 Bessam Charfeddine,3 Mohamed Ridha Maarouf,4 Zouhair Tabka,1,5 Abdelkrim Zbidi,1,5 Helmi Ben Saad1,51Laboratory of Physiology, University of Sousse, 2Department of Physical Medicine. Sahloul Hospital, 3Laboratory of Biochemistry, Basic Health Group, 4Basic Health Group, 5Department of Physiology and Functional Exploration, Farhat Hached Hospital, Sousse, TunisiaIntroduction: International recommendations of the exploration of non-insulin-dependent diabetes mellitus (NIDDM) are focused on deficiency and not incapacity.Aims: (1) To estimate the incapacity of NIDDM patients through the 6-minute walk test (6MWT) data. (2) To determine their 6-minute walk distance (6MWD) influencing factors (3) To compare data of NIDDM patient group (PG; n = 100) with those of two control groups (CG): CG1 (n = 174, healthy nonobese and nonsmoker); CG2 (n = 55, obese nondiabetic free from comorbidities).Population and methods: The anthropometric, socioeconomic, clinical, metabolic, and 6MWT data of 100 NIDDM patients (45 females) were collected.Results: Total sample means ± standard deviation of age, weight, and height were 54 ± 8 years, 81 ± 14 kg, and 1.64 ± 0.09 m. (1) Measured 6MWD (566 ± 81 m) was significantly lower than the theoretical 6MWD (90% ± 12%). The profile of the PG carrying the 6MWT, was as follows: 23% had an abnormal 6MWD; at the end of the 6MWT, 21% and 12% had, respectively, a low heart rate and a high dyspnea (>5/10), and 4% had desaturation during the walk. The estimated "cardiorespiratory and muscular chain" age (68 ± 16 years) was significantly higher than the chronological age. (2) The factors that significantly influenced the 6MWD (r2 = 0.58) are included in the following equation: 6MWD (m) = –73.94 × gender (0, male; 1, female) – 3.25 × age (years) + 7.33 × leisure activity score – 35.57 × obesity (0, no; 1, yes) + 32.86 × socioeconomic level (0, low; 1, high) – 27.67 × cigarette use (0, no; 1, yes) + 8.89 × resting oxyhemoglobin saturation – 105.48. (3) Compared to the CGs, the PG had a significantly (P < 0.05) lower 6MWD (100%+9% and 100%+8%, respectively, for the CG1 and CG2).Conclusion: NIDDM seems to accelerate the decline of the submaximal aerobic capacity evaluated through the 6MWD.Keywords: 6-minute walk test, non-insulin-dependent diabetes mellitus, physical activity, functional incapacity

Published
2012

47. Overdiagnosis of COPD in Subjects With Unobstructed Spirometry: A BOLD Analysis

Author

Sator, L, Horner, A, Studnicka, M, Lamprecht, B, Kaiser, B, McBurnie, M, Buist, A, Gnatiuc, L, Mannino, D, Janson, C, Bateman, E, Burney, P, Zhong, N, Liu, S, Lu, J, Ran, P, Wang, D, Zheng, J, Zhou, Y, Kocabaş, A, Hancioglu, A, Hanta, I, Kuleci, S, Turkyilmaz, A, Umut, S, Unalan, T, Dawes, T, Jithoo, A, Adams, D, Barnes, E, Freeman, J, Hayes, A, Hlengwa, S, Johannisen, C, Koopman, M, Louw, I, Ludick, I, Olckers, A, Ryck, J, Storbeck, J, Gislason, T, Benedikdtsdottir, B, Jörundsdottir, K, Gudmundsdottir, L, Gudmundsdottir, S, Gundmundsson, G, Nizankowska-Mogilnicka, E, Frey, J, Harat, R, Mejza, F, Nastalek, P, Pajak, A, Skucha, W, Szczeklik, A, Twardowska, M, Welte, T, Bodemann, I, Geldmacher, H, Schweda-Linow, A, Gulsvik, A, Endresen, T, Svendsen, L, Tan, W, Wang, W, Cain, J, Copeland, R, Hazen, D, Methvin, J, Dantes, R, Amarillo, L, Berratio, L, Fernandez, L, Francisco, N, Garcia, G, De Guia, T, Idolor, L, Naval, S, Reyes, T, Roa, C, Sanchez, M, Simpao, L, Jenkins, C, Marks, G, Bird, T, Espinel, P, Hardaker, K, Toelle, B, Amor, C, Potts, J, Tumilty, M, McLean, F, Wouters, E, Wesseling, G, Bárbara, C, Rodrigues, F, Dias, H, Cardoso, J, Almeida, J, Matos, M, Simão, P, Santos, M, Ferreira, R, Olafsdottir, I, Nisser, K, Spetz-Nyström, U, Hägg, G, Lund, G, Jõgi, R, Laja, H, Ulst, K, Zobel, V, Lill, T, Koul, P, Malik, S, Hakim, N, Khan, U, Chowgule, R, Shetye, V, Raphael, J, Almeda, R, Tawde, M, Tadvi, R, Katkar, S, Kadam, M, Dhanawade, R, Ghurup, U, Harrabi, I, Denguezli, M, Tabka, Z, Daldoul, H, Boukheroufa, Z, Chouikha, F, Khalifa, W, Ayuyao, F, Tady, C, Tan, D, Banal-Yang, S, Balanag, V, Reyes, M, Juvekar, S, Hirve, S, Sambhudas, S, Chaidhary, B, Tambe, M, Pingale, S, Umap, A, Shelar, N, Devchakke, S, Chaudhary, S, Bondre, S, Walke, S, Gawhane, A, Sapkal, A, Argade, R, Gaikwad, V, Salvi, S, Brashier, B, Londhe, J, Madas, S, Obaseki, D, Erhabor, G, Awopeju, O, and Adewole, O

Subjects
respiratory tract diseases
Abstract

Background There are several reports on underdiagnosis of COPD, while little is known about COPD overdiagnosis and overtreatment. We describe the overdiagnosis and the prevalence of spirometrically defined false positive COPD, as well as their relationship with overtreatment across 23 population samples in 20 countries participating in the BOLD Study between 2003 and 2012. Methods A false positive diagnosis of COPD was considered when participants reported a doctor’s diagnosis of COPD, but postbronchodilator spirometry was unobstructed (FEV1/FVC > LLN). Additional analyses were performed using the fixed ratio criterion (FEV1/FVC < 0.7). Results Among 16,177 participants, 919 (5.7%) reported a previous medical diagnosis of COPD. Postbronchodilator spirometry was unobstructed in 569 subjects (61.9%): false positive COPD. A similar rate of overdiagnosis was seen when using the fixed ratio criterion (55.3%). In a subgroup analysis excluding participants who reported a diagnosis of “chronic bronchitis” or “emphysema” (n = 220), 37.7% had no airflow limitation. The site-specific prevalence of false positive COPD varied greatly, from 1.9% in low- to middle-income countries to 4.9% in high-income countries. In multivariate analysis, overdiagnosis was more common among women, and was associated with higher education; former and current smoking; the presence of wheeze, cough, and phlegm; and concomitant medical diagnosis of asthma or heart disease. Among the subjects with false positive COPD, 45.7% reported current use of respiratory medication. Excluding patients with reported asthma, 34.4% of those with normal spirometry still used a respiratory medication. Conclusions False positive COPD is frequent. This might expose nonobstructed subjects to possible adverse effects of respiratory medication.

Published
2019

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