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Abstract Chronic Obstructive Lung Disease (COPD), a common preventable and treatable disease, characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases. Metabolic Syndrome is a complex disorder defined by the presence of abdominal obesity, namely waist circumference above cutoff values with ethnicity specifications or body mass index (BMI) [30 kg/m2, in addition to any two of the following criteria: elevated triglyceride level, elevated blood pressure, high blood glucose or insulin resistance and atherogenic dyslipidemia [54]. Development of both COPD and MetS includes common risk factors that may cross-relate in the individual patient. Notably, a link between obesity, MetS and COPD is increasingly recognized; epidemiological data confirm the relationship between these conditions [151]. Impairment of lung function is strongly related to central obesity. Moreover, a recent large study found that airway obstruction is directly related to the presence of MetS (low high-density lipoprotein cholesterol, high triglycerides, high fasting glycemia, high blood pressure and large waist circumference), whereas central obesity is the strongest predictor of lung function impairment for both forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC). Both COPD and MetS share a low-grade systemic inflammatory profile in both stable and acute phase. CRP and ESR were used in many studies for years ,CRP is more sensitive than ESR in detecting inflammatory process due to its rapid changes in response to inflammation [110]. The aim of the present work was to study the incidence of metabolic syndrome in COPD patients and to evaluate the role of CRP as an inflammatory marker in COPD patients with or without metabolic syndrome. This prospective case-control study was carried out on thirty patients with stable COPD who were recruited from the outpatient clinic of the Chest hospital in Shebin El Kom and twenty healthy subjects that served as control group. Pulmonary function tests (FEV1, FVC, FEV1/FVC) were measured according to the American Thoracic Society criteria. COPD was diagnosed using GOLD criteria: postbronchodilator FEV1/ FVC ratio less than 70%. COPD staging was done according to GOLD (2014) criteria. All of the study population, after having a written informed consent, were subjected to history taking, clinical examination, anthropometric measurements, fasting blood glucose, complete blood picture, complete liver and kidney functions, LDH, HDL-cholesterol, triglycerides, serum uric acid and CRP. Patients were subclassified according to the presence or absence of MetS which was defined as abdominal obesity (waist circumference of 95 cm in males and 80 cm in females) plus any two of the four following criteria: a) Increased blood pressure (130/85 mmHg); b) Insulin resistance (fasting plasma glucose (FPG)≥100 mg); c) Increased triglyceride levels (≥ 150 mg/dl); d) Reduced HDL–cholesterol level (< 40 mg/dl for men, < 50 mg/dl for women) according to the International Diabetes Federation (IDF) criteria. There was no statistically significant difference between both patients and controls regarding age(51.23±5.00 and 50.45±5.41 years respectively) There were no statistically significant differences between both patient and control groups regarding body mass index (BMI), BMI classification and waist circumference. There was a highly statistically significant difference in systolic blood pressure, and a statistically significant difference in diastolic blood pressure. There were highly statistically significant differences between both patient and control groups regarding cholesterol and fasting blood sugar level, and statistically significant differences regarding HDL and LDL levels. However, there was no statistically significant difference regarding triglycerides level. Highly statistically significant differences were found between both patient and control groups regarding CRP and uric acid levels and the prevalence of metabolic syndrome. No statistically significant difference between different GOLD stages regarding the prevalence of metabolic syndrome or CRP level was described. But there was a significant positive correlation between pack.year index and CRP level. Abdominal obesity, hypertension and hyperglycemia were significantly higher in COPD patients Within the COPD group who had no significant difference in pack.year index CRP was significantly higher in patients with MetS. CRP level didn’t vary significantly in patients with and without MetS of different GOLD stages. The receiver operating characteristics (ROC) curve for CRP to predict the presence of MetS in patients with COPD demonstrated that a cut-off point for CRP >14 mg/L can detect the presence or absence of MetS in patients with COPD with a sensitivity of (95% CI) 88.89 % (65.3 - 98.6) and a specificity of (95% CI) 83.33 % (51.6 - 97.9) |