Metabolic and functional predictors of severity of disease and thoracal influence in chronic obstructive pulmonary disease

Along with chronic obstructive pulmonary disease (COPD) is a multisystemic disease, changes can be seen in the thoracic region-related musculoskeletal structure, metabolic values and functional capacity. The aim of this study was to determine the metabolic factors, functional capacity, musculoskeletal system related to the thoracic region involvement, pain severity and COPD-related quality of life and depression status in patients diagnosed with chronic obstructive pulmonary disease (COPD).Sixteen females and forty-six males aged 58.1±7.3 years who were diagnosed with COPD, did not receive any oncological or osteoporotic treatment, and did not undergo spinal surgery were included to the study. COPD symptoms assessed with the COPD Assessment Test (CAT), with the Modified Medical Research Council (mMRC) dyspnea scale, and exacerbation histories of the patients were asked. Pulmonary function test by spirometry, functional capacity by 6- minute walk test (6 MWT) and timed up-go test, pain intensity using visual analog scale, neuropathic pain level using Leeds Neuropathic Pain Scale, quality of life and psychological status evaluation with St. George Respiratory Questionnaire and Beck Depression Scale were performed. Chest circumference measurement, muscle flexibility tests, manual assessment of respiratory movement, Corbin Posture Analysis were applied to examine thoracic region involvement. Hematological parameters of the last 6 months were recorded to examine metabolic markers. The patients were grouped according to GOLD ABE Assestment Tool as A, B or E and Global iniative for chronic Obstructive Lung Disease (GOLD) airflow limitation severity as mild and moderate. It was found that with the increase in the severity of the disease, the hematological parameters such as high-density lipoprotein (HDL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), C-reactive protein (CRP) levels increased, the difference in axillary and thoracic sirtometry decreased and the thoracic pain at rest and during activity increased, the quality of life decreased, and the state of depression increased. (p<0.05). With Logistic Regression analysis, it was determined that the transition from mild severity group to moderate severity group according to GOLD airflow classification increased approximately 9 times with a unit increase in CAT staging, and a unit increase in age increased the transition 1.2 times. It was determined that this transition increased with the increase in serum triglyceride level and the decrease in the 6 MWT distance (R 2=0,42). We emphasize that thoracic region-related conditions, decreases in functional exercise capacity and changes in metabolic status, which we found to be adversely affected by disease severity, are parameters that should be considered during the evaluation phase. Keywords: Pulmonary Disease, Chronic Obstuctive; Cardiometabolic Risk Factors; Exercise Test; Thorax