ABSTRACT
Background : Post-occlusive reactive hyperemia (RH) is impaired in Chronic Obstructive Pulmonary Disease (COPD) and Obstructive Sleep Apnea (OSA). The aim of the present study was to examine systemic vascular response and endothelial function in patients of Overlap Syndrome (OS) of COPD and OSA and also to investigate whether OS has any additional effect on endothelial dysfunction when compared to dysfunction caused by COPD alone. Methods : 31 COPD patients and 13 healthy controls participated in the study. Overnight Polysomnography was done to classify the patients into COPD only group (Apnea-Hypopnea Index <5) (n=15) and OS group (AHI >5) (n=16). Peripheral pulse waveform changes during reactive hyperemia were assessed using digital Photoplethysmography (PPG) technique in which pulse wave amplitude (PWA), Maximum slope of upstroke and Pulse Transit Time (PTT) were measured. C - reactive protein was assessed as marker of inflammation by ELISA. Results : Maximum percentage changes in PWA during RH were significantly lower in the both COPD group [20.34(12.02-34.07)] (p<0.001) and Overlap Syndrome group [10.96(6.21-21.49)] (p<0.0001) as compared to Controls [49.79(46.03-65.32)], whereas amplitude responses were not significantly different in the COPD and OS group (p>0.05). Maximum percentage change in slope of upstroke showed similar responses in the three groups. CRP levels (mg/l) were raised in COPD [11.60(1.75-15.00] (p<0.001) and OS group [12.52(5.28- 15.70))](p<0.0001) as compared to controls [0.59(0.58-0.91)]. Maximum percentage change in amplitude negatively correlated with serum CRP levels in COPD group (r=-0.557, p=0.03) and in OS group (r=-0.552, p= 0.02). FEV1% predicted positively correlated with maximum percentage change in amplitude in OS group
ABSTRACT
Obesity and insulin resistance (IR) are associated with type 2 diabetes mellitus (DM). Obesity can be quantified by body mass index (BMI) and waist circumference (WC). Similarly, IR is commonly quantified by fasting-plasma-insulin (FPI) and Homeostatic model assessment (HOMA-IR). We aimed our study to find correlation between obesity-parameters and IR especially in the Indian population where despite lower BMI there is more prevalence of type 2 DM. In 34 uncomplicated patients of type 2 DM weight and WC were measured and BMI was calculated. HOMA-IR and FPI level were estimated to assess IR. Significant correlation was found between HOMA-IR and WC (r = +0.368, P = 0.0324) but it was non-significant between HOMAIR and BMI. Correlations were also not significant between FPI and WC or BMI.In conclusion, HOMA-IR and WC are better measures of IR and obesity as compared to FPI and BMI, respectively in type 2 DM.
ABSTRACT
Obesity and insulin resistance (IR) are associated with type 2 diabetes mellitus (DM). Obesity can be quantified by body mass index (BMI) and waist circumference (WC). Similarly, IR is commonly quantified by fasting-plasma-insulin (FPI) and Homeostatic model assessment (HOMA-IR). We aimed our study to find correlation between obesity-parameters and IR especially in the Indian population where despite lower BMI there is more prevalence of type 2 DM. In 34 uncomplicated patients of type 2 DM weight and WC were measured and BMI was calculated. HOMA-IR and FPI level were estimated to assess IR. Significant correlation was found between HOMA-IR and WC (r = +0.368, P = 0.0324) but it was non-significant between HOMAIR and BMI. Correlations were also not significant between FPI and WC or BMI.In conclusion, HOMA-IR and WC are better measures of IR and obesity as compared to FPI and BMI, respectively in type 2 DM.