• Tuberculosis and Respiratory Diseases
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• v.80 no.3
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• pp.304-310
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• 2017

Background: Chronic obstructive pulmonary disease (COPD), is a chronic inflammatory disorder. We evaluated whether white blood cell (WBC) count, is associated with the severity of COPD, independent of other inflammatory conditions, such as metabolic syndrome. Methods: The WBC counts were compared between 1227 COPD patients and 8679 non-COPD adults older than 40. The relationships between the WBC count, lung function, and symptoms score in COPD patients, were determined, using general linear regression analyses. Results: The WBC count was negatively associated with forced vital capacity (FVC, L), FVC (% predicted), forced expiry volume in one second ($FEV_1$, L), and $FEV_1$ (% predicted) in COPD patients. Additionally, the WBC count was independently associated with the quality of life measure, by EQ5D-index score. However, this relationship between WBC count, and disease severity, was not significant in current smokers, because of the confounding effect of smoking, on the WBC count. Conclusion: The WBC count is associated with current smoking status and COPD severity, and a risk factor for poor lung function, and quality of life, especially in non-currently smoking COPD patients. The WBC count can be used, as an easily measurable COPD biomarker.

• Tuberculosis and Respiratory Diseases
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• v.85 no.3
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• pp.205-220
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• 2022

This study aimed to describe the prevalence of comorbidities associated with chronic obstructive pulmonary disease (COPD) and their relation with relevant outcomes. A systematic review based on the PRISMA methodology was performed from January 2020 until July 2021. The MEDLINE, Lilacs, and Scielo databases were searched to identify studies related to COPD and its comorbidities. Observational studies on the prevalence of comorbidities in COPD patients and costs with health estimates, reduced quality of life, and mortality were included. Studies that were restricted to one or more COPD pain assessments and only specific comorbidities such as osteoporosis, bronchitis, and asthma were excluded. The initial search identified 1,409 studies and after applying the inclusion and exclusion criteria, 20 studies were finally selected for analysis (comprising data from 447,459 COPD subjects). The most frequent COPD comorbidities were: hypertension (range, 17%-64.7%), coronary artery disease (19.9%-47.8%), diabetes (10.2%-45%), osteoarthritis (18%-43.8%), psychiatric conditions (12.1%-33%), and asthma (14.7%-32.5%). Several comorbidities had an impact on the frequency and severity of COPD exacerbations, quality of life, and mortality risk, in particular malignancies, coronary artery disease, chronic heart failure, and cardiac arrhythmias. Comorbidities, especially cardiovascular diseases and diabetes, are frequent in COPD patients, and some of them are associated with higher mortality.

• Journal of Korean Academy of Nursing
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• v.52 no.5
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• pp.522-534
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• 2022

Purpose: This study examined the validity and reliability of the Korean version of the Self-Care in Chronic Obstructive Pulmonary Disease Inventory (SC-COPDI) and the Chronic Obstructive Pulmonary Disease Self-Care Self-Efficacy Scale (SCES-COPD). The SC-COPDI consists of the Self-Care Maintenance Scale (SCMES), Self-Care Monitoring Scale (SCMOS), and Self-Care Management Scale (SCMAS). Methods: The original tool was translated using a back-translation process. Participants were 241 patients with COPD at the Chonnam National University Hospital in Korea. The construct validity was verified through confirmatory factor analysis, and reliability was verified using Cronbach's α. Results: The SCMES consisted of 10 items of three factors-one of four factors was deleted from the original tool. In the SCMOS, there were six items of two factors after two items were deleted from the original tool. The SCMAS consisted of the original 10 items of three factors. The SCES-COPD consisted of six items of two factors, with one item removed from the original tool. The model fit indices of all tools were good, and the construct validity was confirmed. Cronbach's α of SCMES was .72, SCMOS was .90, SCMAS was .81, and SCES-COPD was .85. Conclusion: The Korean version of SC-COPDI and SCES-COPD are valid and reliable instruments for measuring self-care in people with COPD. These instruments can be used in self-care studies of COPD patients in Korea.

• Korean Journal of Clinical Pharmacy
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• v.32 no.3
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• pp.155-165
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• 2022

Background: Chronic obstructive pulmonary disease (COPD) is not completely reversible and requires long-term management with appropriate treatment. This study aimed to analyze trends in treatment regimens and medication costs for COPD patients using a national claims database. Methods: We conducted this analysis using National Patient Sample data from the Health Insurance Review and Assessment Service covering the period from 2015 to 2018. We have constructed a dataset comprising COPD disease classification codes J43.x and J44.x (based on KCD-7 code, J43.0 was excluded) and compiled a list of drugs fitting current guidelines. To identify trends, we calculated frequency, ratio, and compound annual growth rate (CAGR) using the numbers of prescriptions and patients. Results: The number of COPD patients was 7,260 in 2018, slightly decreased from 2015. Most of these COPD patients were aged 60 or older and included a high proportion of males (72.2%; 2018). The number of patients prescribed inhaled medications increased gradually from 2015 to 2018 (9,227 (47.1%); 2015, 9,285 (51.5%); 2018), while the number of patients prescribed systemic beta-agonists and Xanthines has decreased since 2015 (CAGR -14.7; systemic beta-agonist, -5.8; Xanthines). The per capita cost of medication has increased by 0.4% (KRW 206,667; 2018, KRW 204,278; 2015) annually during the study period. Conclusion: This study showed that treatment with inhaled medications had continuously increased in accord with changing guidelines, but oral medications were still widely used. It is necessary to emphasize the importance of inhaled medications in treating COPD to reduce additional economic burden through appropriate medication use.

• Sleep Medicine and Psychophysiology
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• v.15 no.2
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• pp.67-70
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• 2008

Overlap syndrome can be defined as a coexistence of chronic obstructive pulmonary disease (COPD) and sleep apnea-hypopnea syndrome (SAHS). The association of COPD and SAHS has been suspected because of the frequency of both diseases. Prevalence of COPD and SAHS is respectively 10 and 5% of the adult population over 40 years of age. However, a recent study has shown that the prevalence of SAHS is not higher in COPD than in the general population. The coexistence of the two diseases is only due to chance. SAHS does not affect the pathophysiology of COPD and vice versa. Prevalence of overlap syndrome is expected to occur in about 0.5% of the adult population over 40 years of age. Patients with overlap syndrome have a more profound hypoxemia, hypercapnia, and pulmonary hypertension when compared with patients with SAHS alone or usual COPD patients without SAHS. To treat the overlap syndrome, nocturnal noninvasive ventilation (NIV) or nasal continuous positive airway pressure (nCPAP) can be applied with or without nocturnal oxygen supplement.

• Tuberculosis and Respiratory Diseases
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• v.80 no.1
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• pp.11-20
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• 2017

Approximately one in four patients with chronic obstructive pulmonary disease (COPD) have asthmatic features consisting of wheezing, airway hyper-responsiveness or atopy. The Global initiative for Asthma/Globalinitiative for chronic Obstructive Lung Disease committee recently labelled these patients as having asthma-COPD overlap syndrome or ACOS. ACOS also encompasses patients with asthma, ${\geq}40$ years of age, who have been cigarette smokers (more than 5-10 pack years) or have had significant biomass exposure, and demonstrate persistent airflow limitation defined as a post-bronchodilator forced expiratory volume in 1 second ($FEV_1$)/forced vital capacity of <70%. Data over the past 30 years indicate that patients with ACOS have greater burden of symptoms including dyspnea and cough and show higher risk of COPD exacerbations and hospitalizations than those with pure COPD or pure asthma. Patients with ACOS also have increased risk of rapid $FEV_1$ decline and COPD mortality. Paradoxically, experimental evidence to support therapeutic decisions in ACOS patients is lacking because traditionally, patients with ACOS have been systematically excluded from therapeutic COPD and asthma trials to maintain homogeneity of the study population. In this study, we summarize the current understanding of ACOS, focusing on definitions, epidemiology and patient prognosis.

• Journal of Yeungnam Medical Science
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• v.21 no.2
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• pp.133-142
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• 2004

Chronic obstructive pulmonary disease(COPD) is characterized by a not entirely reversible limitation in the airflow. An airflow limitation is progressive and associated with an abnormal inflammatory response of the lung to gases and harmful particles. In COPD, the weight loss is commonly observed and there is a negative impact on the respiratory as well as skeletal muscle function. The pathophysiological mechanisms that result in weight loss in COPD are not fully understood. However, the mechanisms of weight loss in COPD may be the result of an increased energy expenditure unbalanced by an adequate dietary intake. The commonly occurring weight loss and muscle wasting in COPD patients adversely affect the respiratory and peripheral muscle function, the exercise capacity, the health status, and even the survival rates. Therefore, it is very valuable to include management strategies that the increase energy balance in order to increase the weight and fat free mass. A Better understanding of the molecular and cellular pathological mechanisms of COPD can improve the many new directions for both the basic and clinical investigations. The Nutritional supply is an important components of a multidisciplinary pulmonary rehabilitation program. Future studies combining an exercise program, the role of anabolic steroids, nutritional individualization, a more targeted nutritional therapy, and the development of new drugs including anti-cytokines is needed for the effective management of COPD.

• Journal of Microbiology and Biotechnology
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• v.33 no.9
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• pp.1111-1118
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• 2023

As a long-term condition that affects the airways and lungs, chronic obstructive pulmonary disease (COPD) is characterized by inflammation, emphysema, breathlessness, chronic cough, and sputum production. Currently, the bronchodilators and anti-inflammatory drugs prescribed for COPD are mostly off-target, warranting new disease management strategies. Accumulating research has revealed the gut-lung axis to be a bidirectional communication system. Cigarette smoke, a major exacerbating factor in COPD and lung inflammation, affects gut microbiota composition and diversity, causing gut microbiota dysbiosis, a condition that has recently been described in COPD patients and animal models. For this review, we focused on the gut-lung axis, which is influenced by gut microbial metabolites, bacterial translocation, and immune cell modulation. Further, we have summarized the findings of preclinical and clinical studies on the association between gut microbiota and COPD to provide a basis for using gut microbiota in therapeutic strategies against COPD. Our review also proposes that further research on probiotics, prebiotics, short-chain fatty acids, and fecal microbiota transplantation could assist therapeutic approaches targeting the gut microbiota to alleviate COPD.

• Tuberculosis and Respiratory Diseases
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• v.40 no.2
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• pp.147-152
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• 1993

Background: There is evidence that platelet is activated in chronic obstructive pulmonary disease and activated platelet with injured endothelium contribute to the pathogenesis of pulmonary hypertension, prognostic factor of chronic obstructive pulmonary disease. So, we have investigated platelet function further in chronic obstructive pulmonary disease and effect of platelet activation on pulmonary hypertension. Method: We studied platelet aggregation ratio and alpha-granule products such as platelet factor 4(PF4) and beta-thromboglobulin (${\beta}$-TG) in control subjects and COPD without and with pulmonary hypertension subjects. Result: 1) The platelet aggregation ratio (PAR) was $0.99{\pm}0.04$ in control subjects, $0.98{\pm}0.05$ in COPD without pulmonary hypertension subjects and $0.89{\pm}0.08$ in COPD with pulmonary hypertension subjects. The platelet aggregation ratio of COPD subjects was tend to decrease than that of control subjects and the ratio of COPD with pulmonary hypertension subjects was significantly lower than that of control subjects. 2) The platelet factor 4 (PF4, IU/ml) was $4.7{\pm}1.2$ in control subjects, $18.6{\pm}4.9$ in COPD without pulmonary hypertension subjects and $57.2{\pm}12.7$ in COPD with pulmonary hypertension subjects. The level of COPD subjects was significantly higher than that of control subjects and the level of COPD with pulmonary hypertension subjects was significantly higher than that of COPD without pulmonary hypertension subjects. 3) The beta-thromboglobulin (${\beta}$-TG, IU/ml) was $34.4{\pm}5.8$ in control subjects, $80.4{\pm}18.1$ in COPD without pulmonary hypertension subjects and $93.0{\pm}14.0$ in COPD with pulmonary hypertension subjects. The level of COPD subjects was significantly higher than that of conrtrol subjects and the level of COPD with pulmonary hypertension subjects was tend to increase than that of COPD without pulmonary hypertension subjects. 4) There was no correlation between the clinical parameters and PAR, PF4 and ${\beta}$-TG but there was significant correlation among PAR, PF4 and ${\beta}$-TG. Conclusion: The platelet is activated in chronic obstructive pulmonary disease and the platelet of COPD with pulmonary hypertension is tend to be activated more than that of COPD without pulmonary hypertension. So, activated platelet may involve in the pathogenesis and maintenance of pulmonary hypertension in COPD subjects and modulation of platelet activity that might reduce pulmonary hypertension needs to be determined.

• Journal of Nutrition and Health
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• v.47 no.5
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• pp.321-329
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• 2014

Purpose: The aim of this study was to determine the relationship between serum concentrations of 25-hydroxyvitamin D [25(OH)D] and chronic obstructive pulmonary disease (COPD) prevalence. Methods: The analysis was performed using data from the Fifth Korean National Health and Nutrition Examination Survey, a cross-sectional survey of the Korean civilian population conducted from 2010 to 2012. The analyses were restricted to males who were 40 years of age and above. Complex sample multiple logistic regression analyses were used to examine the associations of COPD prevalence with 25(OH)D and other factors. Results: $FEV_1/FEV_6$ varied significantly with smoking status, age, household income, education level, occupation, body mass index (BMI), and physical activity (p < 0.05). In univariate analysis, smoking status, BMI, household income, education level, and occupation showed association with COPD (p < 0.05), but vitamin D was not associated with COPD (p = 0.078). However, when adjusted with smoking status, household income, education level, occupation, BMI, age, and smoking index, the lowest quartile of 25(OH)D showed OR 1.643 (95% CI 1.161-2.236) compared to 3rd quartile (p = 0.024). Conclusion: A significant relationship was observed between serum concentration of 25(OH)D and COPD.