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The impact of COPD on polyneuropathy: results from the German COPD cohort COSYCONET.
- Source :
-
Respiratory research [Respir Res] 2020 Jan 20; Vol. 21 (1), pp. 28. Date of Electronic Publication: 2020 Jan 20. - Publication Year :
- 2020
-
Abstract
- Background: Peripheral neuropathy is a common comorbidity in COPD. We aimed to investigate associations between alterations commonly found in COPD and peripheral neuropathy, with particular emphasize on the distinction between direct and indirect effects.<br />Methods: We used visit 4 data of the COPD cohort COSYCONET, which included indicators of polyneuropathy (repeated tuning fork and monofilament testing), excluding patients with diabetes a/o increased HbA1c. These indicators were analysed for the association with COPD characteristics, including lung function, blood gases, 6-min walk distance (6-MWD), timed-up-and-go-test (TUG), exacerbation risk according to GOLD, C-reactive protein (CRP), and ankle-brachial index (ABI). Based on the results of conventional regression analyses adjusted for age, BMI, packyears and gender, we utilized structural equation modelling (SEM) to quantify the network of direct and indirect relationships between parameters.<br />Results: 606 patients were eligible for analysis. The indices of polyneuropathy were highly correlated with each other and related to base excess (BE), ABI and TUG. ABI was linked to neuropathy and 6-MWD, exacerbations depended on FEV <subscript>1</subscript> , 6-MWD and CRP. The associations could be summarized into a SEM comprising polyneuropathy as a latent variable (PNP) with three measured indicator variables. Importantly, PNP was directly dependent on ABI and particularly on BE. When also including patients with diabetes and/or elevated values of HbA1c (n = 742) the SEM remained virtually the same.<br />Conclusion: We identified BE and ABI as major determinants of peripheral neuropathy in patients with COPD. All other associations, particularly those with lung function and physical capacity, were indirect. These findings underline the importance of alterations of the micromilieu in COPD, in particular the degree of metabolic compensation and vascular status.
- Subjects :
- Aged
Ankle Brachial Index trends
Cohort Studies
Comorbidity
Cross-Sectional Studies
Female
Germany epidemiology
Humans
Male
Middle Aged
Polyneuropathies diagnosis
Pulmonary Disease, Chronic Obstructive diagnosis
Polyneuropathies epidemiology
Polyneuropathies physiopathology
Pulmonary Disease, Chronic Obstructive epidemiology
Pulmonary Disease, Chronic Obstructive physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1465-993X
- Volume :
- 21
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Respiratory research
- Publication Type :
- Academic Journal
- Accession number :
- 31959163
- Full Text :
- https://doi.org/10.1186/s12931-020-1293-6