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The impact of COPD on polyneuropathy: results from the German COPD cohort COSYCONET
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. METHODS: We used visit 4 data of the COPD co...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971882/ https://www.ncbi.nlm.nih.gov/pubmed/31959163 http://dx.doi.org/10.1186/s12931-020-1293-6 |
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author | Kahnert, K. Föhrenbach, M. Lucke, T. Alter, P. Trudzinski, F. T. Bals, R. Lutter, J. I. Timmermann, H. Söhler, S. Förderreuther, S. Nowak, D. Watz, H. Waschki, B. Behr, J. Welte, T. Vogelmeier, C. F. Jörres, R. A. |
author_facet | Kahnert, K. Föhrenbach, M. Lucke, T. Alter, P. Trudzinski, F. T. Bals, R. Lutter, J. I. Timmermann, H. Söhler, S. Förderreuther, S. Nowak, D. Watz, H. Waschki, B. Behr, J. Welte, T. Vogelmeier, C. F. Jörres, R. A. |
author_sort | Kahnert, K. |
collection | PubMed |
description | 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. 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. 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(1), 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. 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. |
format | Online Article Text |
id | pubmed-6971882 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-69718822020-01-27 The impact of COPD on polyneuropathy: results from the German COPD cohort COSYCONET Kahnert, K. Föhrenbach, M. Lucke, T. Alter, P. Trudzinski, F. T. Bals, R. Lutter, J. I. Timmermann, H. Söhler, S. Förderreuther, S. Nowak, D. Watz, H. Waschki, B. Behr, J. Welte, T. Vogelmeier, C. F. Jörres, R. A. Respir Res Research 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. 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. 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(1), 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. 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. BioMed Central 2020-01-20 2020 /pmc/articles/PMC6971882/ /pubmed/31959163 http://dx.doi.org/10.1186/s12931-020-1293-6 Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Kahnert, K. Föhrenbach, M. Lucke, T. Alter, P. Trudzinski, F. T. Bals, R. Lutter, J. I. Timmermann, H. Söhler, S. Förderreuther, S. Nowak, D. Watz, H. Waschki, B. Behr, J. Welte, T. Vogelmeier, C. F. Jörres, R. A. The impact of COPD on polyneuropathy: results from the German COPD cohort COSYCONET |
title | The impact of COPD on polyneuropathy: results from the German COPD cohort COSYCONET |
title_full | The impact of COPD on polyneuropathy: results from the German COPD cohort COSYCONET |
title_fullStr | The impact of COPD on polyneuropathy: results from the German COPD cohort COSYCONET |
title_full_unstemmed | The impact of COPD on polyneuropathy: results from the German COPD cohort COSYCONET |
title_short | The impact of COPD on polyneuropathy: results from the German COPD cohort COSYCONET |
title_sort | impact of copd on polyneuropathy: results from the german copd cohort cosyconet |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971882/ https://www.ncbi.nlm.nih.gov/pubmed/31959163 http://dx.doi.org/10.1186/s12931-020-1293-6 |
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