Metabolic syndrome in chemical warfare patients with chronic obstructive pulmonary disease

Introduction: Sulfur mustard [SM], a toxic alkylating gas, can cause serious long-term pulmonary complications such as chronic obstructive pulmonary disease [COPD]. Metabolic syndrome [MetS] is one of the important comorbidities of COPD. This study was designed to evaluate the frequency of metabolic syndrome in Iranian chemical warfare patients [CWPs] with COPD

Materials and Methods: Thirty CWPs with a mean age of 46.93 +/- 6.8 were enrolled in this study. The following parameters were studied in: complete pulmonary function tests, health-related quality of life, serum triglycerides [TG], high density lipoprotein [HDL] and fasting blood sugar [FBS] levels. Additionally, 32 COPD patients and 56 healthy persons were considered as control groups who were matched to CWPs

Results: We found a statistically significant difference in the frequency of MetS between the COPD patients and the healthy control group [P=0.04]. Additionally, we observed a statistically significant difference in the mean HDL levels among these groups [P=<0.001]. In the CWPs, the frequency of MetS was significantly decreased in severe to very severe stages [P<0.001]

Conclusion: Our data indicate that metabolic syndrome is frequent in chemical warfare patients, and special attention to this condition in mild to moderate stages is recommended

evaluation of pulmonary function tests in patients with polycystic ovary syndrome

Introduction: Recently a relation between female sex hormones and severity of asthma symptoms has been proposed. As a common endocrine dysfunction, polycystic ovary syndrome [PCOS] could significantly influence the level of sex hormones in PCOS patients. Regarding the possible role of sex hormones in airway physiology, the present study was conducted to survey the effects of PCOS on pulmonary function test parameters

Materials and Methods: In this cross-sectional study 30 recently diagnosed patients with PCOS without history of pulmonary disease were enrolled and 20 healthy women were considered as the control group according to their age, weight, and height. The patients and the controls underwent body plethysmography to measure pulmonary function tests

Results: The mean age of the patients and the controls were 29.43 +/- 7.8 and 30.0 +/- 7.6 years respectively. There were no statistically significant differences in all pulmonary function test parameters between the patients and the controls [p>0.05]. After dividing the patients into 2 groups based on their body mass index [BMI], BMI<25 and BMI>/=25, we found statistically significant differences only in expiratory reserve volume [ERV] and thoracic gas volume [p=0.01 and p=0.01, respectively].Moreover there was statistically moderate inverse correlation between BMI and ERV [r=-0.5, p=0.03]

Conclusion: Our results showed that pulmonary function test parameters are not different in PCOS patients comparing to healthy women. Only the deleterious effects of high BMI on pulmonary function can be occurred in these patients

Clinical value and severity of myocardial perfusion defects in asymptomatic diabetic patients with negative or weakly positive exercise treadmill test

Although coronary artery disease [CAD] is the leading cause of death in type 2 diabetic patients, it is frequently asymptomatic. Myocardial perfusion imaging [MPI] is reported to show ischemia in a significant number of asymptomatic diabetic patients. We studied the prevalence and severity of myocardial perfusion defects in asymptomatic diabetic patients and its clinical impact. One hundred thirty consecutive asymptomatic patients, aged 35-65 years with type 2 diabetes mellitus and with no history of CAD and no cardiac symptoms were recruited in the study. Echocardiography, electrocardiography [ECG], routine laboratory tests and exercise treadmill test [ETT] were performed and patients with weakly positive or negative ETT underwent Dipyridamole MPI. Patients with positive ETT were referred to coronary angiography. Patients were followed for at least 17 months [mean 21.7 months] and any cardiac event was recorded. We studied 81 female and 49 male patients with mean age of 51.8 years. Negative, weakly positive and positive ETT result was noted in 74.3%, 15% and 10.7% respectively.75% of patients with positive ETT had coronary artery disease in angiography. Gated myocardial perfusion SPECT was done in 106 patients. MPI showed reversible defect in 26.9% of the patients with a mean summed stress score of 3.3 +/- 1.8. Follow up completed in 112 patients and only one patient with abnormal MPI underwent coronary angiography followed by PTCA. No cardiac death, MI, UA or hospital admission occurred among our patients during follow up [17-26 months]. Mean stress end diastolic volume [EDV] was significantly higher in patients with reversible defect compared to patients without reversible defect based on MPI findings [62.0 +/- 31.6 Vs 48.5 +/- 18.4 ml, P=0.04]. Blood glucose and HA1c were significantly higher in patients with ischemia compared to patients without ischemia [P<0.05]. Meanwhile the ratio of TG to HDL was 6.06 +/- 3.2 in ischemic patients compared to 4.8 +/- 2.3 in normal subjects [P=0.03]. Reversible defects are commonly seen in myocardial perfusion SPECT in asymptomatic diabetic patients and are mild in severity and not associated with adverse cardiac events. Routine approach for detection of CAD beginning with ETT seems to be appropriate in these patients