Glucose deprivation elicits phenotypic plasticity via ZEB1-mediated expression of NNMT.

OBJECTIVE

Chronic Obstructive Pulmonary Disease (COPD) and Obstructive Sleep Apnea (OSA) are separately associated with several comorbidities. The coexistence of the two diseases, referred to as overlap syndrome, may act as a predisposing factor for a higher prevalence of comorbidities compared to those associated with each disease separately. The objective of the study was to evaluate the relative prevalence of cardiovascular as well as other comorbidities, in patients with the overlap syndrome, as compared to patients that are diagnosed solely with OSA.

PATIENTS AND

METHODS

We examined thirty-eight (38) patients (27 men, 11 women) with coexisting COPD and OSA - overlap syndrome (Group 1) vs. 38 patients with OSA-only (Group 2), matched for sex, age, and Body Mass Index (BMI). All patients underwent pulmonary function tests (PFTs), oximetry and overnight polysomnography and were asked about other coexisting chronic diseases and medications.

RESULTS

The two groups differed significantly, as expected, in PFTs (Forced Vital Capacity - FVC, p=0.005, Forced Expiratory Volume in 1 s - FEV1, p<0.001) and in daytime oximetry (p=0.007). Three (3) overlap (7.89%) and 9 OSA patients (23.69%) had no other known diseases. All others suffered from 1 - ≥ 4 comorbidities. Overlap patients suffered more often from multiple (≥ 4) comorbidities than OSA-only patients (11, 28.95% vs. 4, 10.52%, respectively). The most common coexisting diseases were hypertension (50% vs. 42.1%), cardiovascular disease (CVD) (44.74% vs. 26.31%), diabetes mellitus (DM) (28.95% vs. 13.16%), dyslipidemia (21.05% vs. 26.31%) and depression (7.89% vs. 13.16%).

CONCLUSIONS

We conclude that comorbidities, especially cardiovascular, in patients with overlap syndrome are at least as prevalent as in sleep apneic only patients and may contribute to the overall severity and prognosis of the disease.