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Kahnert, K.* ; Föhrenbach, M.* ; Lucke, T.* ; Alter, P.* ; Trudzinski, F.T.* ; Bals, R.* ; Lutter, J. ; Timmermann, H.* ; Söhler, S.* ; Förderreuther, S.* ; Nowak, D.* ; Watz, H.* ; Waschki, B.* ; Behr, J.* ; Welte, T.* ; Vogelmeier, C.F.* ; Jörres, R.A.*

The impact of COPD on polyneuropathy: Results from the German COPD cohort COSYCONET.

Respir. Res. 21:28 (2020)
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Open Access Gold
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Background Peripheral neuropathy is a common comorbidity in COPD. We aimed to investigate associations between alterations commonly found in COPD and peripheral neuropathy, with particular emphasize on the distinction between direct and indirect effects. Methods We used visit 4 data of the COPD cohort COSYCONET, which included indicators of polyneuropathy (repeated tuning fork and monofilament testing), excluding patients with diabetes a/o increased HbA1c. These indicators were analysed for the association with COPD characteristics, including lung function, blood gases, 6-min walk distance (6-MWD), timed-up-and-go-test (TUG), exacerbation risk according to GOLD, C-reactive protein (CRP), and ankle-brachial index (ABI). Based on the results of conventional regression analyses adjusted for age, BMI, packyears and gender, we utilized structural equation modelling (SEM) to quantify the network of direct and indirect relationships between parameters. Results 606 patients were eligible for analysis. The indices of polyneuropathy were highly correlated with each other and related to base excess (BE), ABI and TUG. ABI was linked to neuropathy and 6-MWD, exacerbations depended on FEV1, 6-MWD and CRP. The associations could be summarized into a SEM comprising polyneuropathy as a latent variable (PNP) with three measured indicator variables. Importantly, PNP was directly dependent on ABI and particularly on BE. When also including patients with diabetes and/or elevated values of HbA1c (n = 742) the SEM remained virtually the same. Conclusion We identified BE and ABI as major determinants of peripheral neuropathy in patients with COPD. All other associations, particularly those with lung function and physical capacity, were indirect. These findings underline the importance of alterations of the micromilieu in COPD, in particular the degree of metabolic compensation and vascular status.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Peripheral Neuropathy ; Copd ; Base Excess ; Ankle-brachial-index; Obstructive Pulmonary-disease; Quality-of-life; Peripheral Neuropathy; Comorbidities; Microcirculation; Association; Population; Capacity; Outcomes; Women
Language english
Publication Year 2020
HGF-reported in Year 2020
ISSN (print) / ISBN 1465-9921
e-ISSN 1465-993X
Journal Respiratory Research
Quellenangaben Volume: 21, Issue: 1, Pages: , Article Number: 28 Supplement: ,
Publisher BioMed Central
Publishing Place Campus, 4 Crinan St, London N1 9xw, England
Reviewing status Peer reviewed
Institute(s) Institute of Health Economics and Health Care Management (IGM)
POF-Topic(s) 80000 - German Center for Lung Research
Research field(s) Genetics and Epidemiology
PSP Element(s) G-501800-533
DOI 10.1186/s12931-020-1293-6
WOS ID WOS:000521280400003
Scopus ID 85078315257
Erfassungsdatum 2020-02-27
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