Pneumologie 2020; 74(S 01): 67
DOI: 10.1055/s-0039-3403206
Posterbegehung (PO11) – Sektion Klinische Pneumologie
Klinische Aspekte der COPD
Georg Thieme Verlag KG Stuttgart · New York

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

Authors

  • K Kahnert

    1   Department of Internal Medicine V, Respiratory Medicine and Thoracic Oncology, Thoracic Oncology Centre Munich, Ludwig-Maximilians-Universität München, Member of the German Center for Lung Research (Dzl Cpc-M)

  • M Foehrenbach

    2   Institute and Clinic for Occupational, Social and Environmental Medicine, LMU Munich

  • T Lucke

    3   Klinikum der Universität München

  • P Alter

    4   Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps University of Marburg (Umr)

  • FC Trudzinski

    5   Innere Medizin V, Pneumologie, Universitätsklinikum des Saarlandes, Homburg

  • R Bals

    6   Innere Medizin V, Pneumologie, Universitätsklinikum des Saarlandes, Homburg

  • J Lutter

    7   Helmholtz Zentrum München, Institut für Gesundheitsökonomie und Management Im Gesundheitswesen; Comprehensive Pneumology Center Munich (Cpc-M), Mitglied des Deutschen Zentrums für Lungenforschung (Dzl)

  • H Timmermann

    8   Schwerpunktpraxis Colonaden Hamburg

  • S Söhler

    9   Philipps-Universität Marburg

  • S Förderreuther

    10   Ludwig-Maximilians-Universität München; Innenstadtklinikum; Neurologischer Konsildienst der LMU

  • D Nowak

    11   Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin; Klinikum der LMU München; Comprehensive Pneumology Center

  • H Watz

    12   Pneumologisches Forschungsinstitut an der Lungenclinic Grosshansdorf

  • B Waschki

    13   Department of General and Interventional Cardiology, University Heart Center Hamburg

  • J Behr

    14   Medizinische Klinik und Poliklinik V, Klinikum der LMU München, Comprehensive Pneumology Center

  • T Welte

    15   Klinik für Pneumologie, Medizinische Hochschule Hannover

  • C Vogelmeier

    16   Innere Medizin, Sp Pneumologie, Universitätsklinikum Gießen u. Marburg, Standort Marburg

  • R Jörres

    17   Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Klinikum der Universität München
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
28. Februar 2020 (online)

Auch verfügbar auf
 

Background: Peripheral neuropathy is a common comorbidity in COPD, for which various associations with COPD characteristics have been reported. We aimed to identify effects of changes associated with COPD on neuropathy, distinguishing between direct and indirect associations.

Methods: We used visit 4 data of the COPD cohort COSYCONET, which included indicators of polyneuropathy (repeated tuning fork, 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-minute walk distance (6-MWD), the 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 depended on 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 BE and ABI. 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 associated with COPD, in particular vascular status and the degree of metabolic compensation.