What are the Differences Between Smoker and Non-smoker COPD Cases? Is it a Different Phenotype?

OBJECTIVE: The most important risk factor for chronic obstructive pulmonary disease (COPD) is smoking. However, more than 25% of patients do not have a history of smoking. The intent of this study is to identify characteristics of COPD patients that are non-smokers.MATERIAL AND METHODS: The records of patients with COPD were retrospectively reviewed. Smoking history, comorbidities, exacerbations, biomass, and environmental tobacco smoke (ETS) exposures were identified. Also, age, gender, pulmonary function test (PFT) values, modified Medical Research Council (mMRC) dyspnea scores were recorded. Non-smokers exposed to any of the COPD risk factors above were grouped and the data were analyzed to determine the specific characteristics of COPD that applied to them.RESULTS: A total of 706 COPD patients were analyzed with a mean age of 67.2 ± 9.4. Of these patients, 93 (13.2%) were female and 613 (86.8%) were male. Of the 706 patients, 128 (18.1%) were non-smokers. The percentage of male patients having COPD was significantly lower in the non-smoker group (P < .001). However, biomass, ETS exposure in childhood, and a history of previous respiratory infection were significantly higher in the non-smoker group (P < .001). The mean body mass index (BMI) was greater in non-smokers than smokers.CONCLUSION: Non-smokers with COPD have more biomass, ETS exposure, and infection history in childhood. They also have less impairment of airflow limitation, better symptom scores, and greater BMIs. Smoking history can be used to determine a different phenotype.

Kaynakça

1. GOLD Executive Committee. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease; 2020.

2. Lee SH, Hwang ED, Lim JE et al. The risk factors and characteristics of COPD among nonsmokers in korea: an analysis of KNHANES IV and V. Lung. 2016;194:353-361. [CrossRef]

3. Halbert RJ, Natoli JL, Gano A et al. Global burden of COPD: systematic review and meta-analysis. Eur Respir J. 2006;28:523- 532. [CrossRef]

4. Townend J, Minelli C, Mortimer K et al. The association between chronic airflow obstruction and poverty in 12 sites of the multinational BOLD study. Eur Respir J. 2017;49:1601880. [CrossRef]

5. Gershon AS, Warner L, Cascagnette P, Victor JC, To T. Lifetime risk of developing chronic obstructive pulmonary disease: a longitudinal population study. Lancet. 2011;378:991-996. [CrossRef]

6. Salvi SS, Barnes PJ. Chronic obstructive pulmonary disease in non-smokers. Lancet. 2009;374:733-743. [CrossRef]

7. Jindal SK. A health perspective of indoor air pollution. Indian J Med Res. 2007;126:409-411.

8. Mortimer K, Gordon SB, Jindal SK et al. Household air pollution is a major avoidable risk factor for cardiorespiratory disease. Chest. 2012;142:1308-1315. [CrossRef]

9. Corlateanua A, Mendez Y, Wang Y et al. Chronic obstructive pulmonary disease and phenotypes: A state-of-the-art. Pulmonology. 2020;26:95-100. [CrossRef]

10. Sana A, Somda SMA, Meda N, Bouland C. Chronic obstructive pulmonary disease associated with biomass fuel use in women: A systematic review and meta-analysis. BMJ Open Respir Res. 2018;12:5. [CrossRef]

11. Eisner MD, Anthonisen N, Coultas D et al. An official american thoracic society public policy statement: novel risk factors and the global burden of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2010;182:693-718. [CrossRef]

12. Han MK, Agusti A, Calverley PM et al. Chronic obstructive pulmonary disease phenotypes: the future of COPD. Am J Respir Crit Care Med. 2010;182:598-604. [CrossRef]

13. Kamal R, Srivastava AK, Kesavachandran CN. Meta-analysis approach to study the prevalence of chronic obstructive pulmonary disease among current, former and non-smokers. Toxicol Rep. 2015;2:1064-1074. [CrossRef]

14. Mahmood T, Singh RK, Kant S et al. Prevalence and etiological profile of chronic obstructive pulmonary disease in nonsmokers. Lung India. 2017;34:122-126. [CrossRef]

15. Bajpai J, Kant S, Bajaj DK et al. Clinical, demographic and radiological profile of smoker COPD versus nonsmoker COPD patients at a tertiary care center in north india. J Fam Med Prim Care. 2019;8:2364-2368. [CrossRef]

16. Ehrlich RI, White N, Norman R et al. Predictors of chronic bronchitis in south african adults. Int J Tuberc Lung Dis. 2004;8:369-376.

17. Salvi S, Barnes PJ. Is exposure to biomass smoke the biggest risk factor for COPD globally? Chest. 2010;138:3-6. [CrossRef]

18. Lindström M, Kotaniemi J, Jönsson E, Lundbäck B. Smoking, respiratory symptoms, and diseases: a comparative study between northern sweden and northern finland: report from the finess study. Chest. 2001;119:852-861. [CrossRef]

19. van Koeverden I, Blanc PD., Bowler RP., Arjomandi M. Secondhand tobacco smoke and COPD risk in smokers: a COPDGene study cohort subgroup analysis. COPD. 2015;12:182- 189. [CrossRef]

20. de Marco R, Accordini S, Marcon A et al. Risk factors for chronic obstructive pulmonary disease in a european cohort of young adults. Am J Respir Crit Care Med. 2011;183:891-897. [CrossRef]

21. Ji W, Lim MN, Bak SH et al. Differences in chronic obstructive pulmonary disease phenotypes between non-smokers and smokers. Clin Respir J. 2018;12:666-673. [CrossRef]

22. Zhang J., Lin XF, Bai CX. Comparison of clinical features between nonsmokers with COPD and smokers with COPD: a retrospective observational study. Int J Chron Obstruct Pulmon Dis. 2014;9:57-63. [CrossRef]

23. Zhong N, Wang C, Yao W et al. Prevalence of chronic obstructive pulmonary disease in China: A large, population-based survey. Am J Respir Crit Care Med. 2007;176:753-760. [CrossRef]

24. Cheng Y, Tu X, Pan L et al. Clinical characteristics of chronic bronchitic, emphysematous and ACOS phenotypes in COPD patients with frequent exacerbations. Int J Chron Obstruct Pulmon Dis. 2017;12:2069-2074. [CrossRef]

25. Mineur YS, Abizaid A, Rao Y et al. Nicotine decreases food intake through activation of POMC neurons. Science. 2011;332:1330-1332. [CrossRef]

Kaynak Göster

Turkish Thoracic Journal
  • ISSN: 2149-2530
  • Yayın Aralığı: Yılda 6 Sayı
  • Başlangıç: 2000
  • Yayıncı: AVES Yayıncılık

277

Sayıdaki Diğer Makaleler

Effect of Obstructive Sleep Apnea on Bone Mineral Density

Shadan SADAF, Mohammad SHAMEEM, Sheelu Shafiq SİDDİQİ, Shahzad ANWAR, Shahnawaz MOHD

What are the Differences Between Smoker and Non-smoker COPD Cases? Is it a Different Phenotype?

Filiz GÜLDAVAL, Gülru POLAT, Sibel DORUK, Gülistan KARADENİZ, Aysu AYRANCI, Merve TÜRK, Mine GAYAF, Melike YÜKSEL YAVUZ, Melih BÜYÜKŞİRİN, Ceyda ANAR

Evaluation of Carbonmonoxide, Diffusion Capacity, Respiratory Muscle Strength Values, and Pulmonary Volume in Smoking Men over 40 Years Old

Kadir Burak AKGÜN, Cengiz ÖZGE, Bahar TAŞDELEN

Maternal and Fetal Problems in Patients with Non-Cystic Fibrosis Bronchiectasis During Pregnancy

Şermin BÖREKÇİ, Bahar KUBAT, Gizem ŞENKARDEŞLER, Benan MÜSELLİM

The Perspective of the Turkish Thoracic Society Members on Institutional Preparedness During the COVID-19 Pandemic in Turkey

Abdulsamet SANDAL, Zehra Nur TÖREYİN, Cüneyt SALTÜRK, Peri Meram ARBAK

Re: Pneumococcal and Influenza Vaccination Status of Hospitalized Adults With Community-Acquired Pneumonia and the Effects of Vaccination on Clinical Presentation

Waseem BANI, Alshimaa ELMASRY, Mohammad Ibrar PERWAIZ, Faris HUSSEIN

The Role of Pneumococcal Pneumonia among Community Acquired Pneumonia in Adult Turkish Population: TurkCAP Study

Esin ŞENOL, Aykut ÇİLLİ, Hakan GÜNEN, Alper ŞENER, Rıdvan DUMLU, Ayşe ÖDEMİŞ, Ayşe Füsun TOPÇU, Yeşim YILDIZ, Rahmet GÜNER, Ayhan ÖZHASENEKLER, Birsen MUTLU, Nurdan KÖKTÜRK, Nurgül SEVİMLİ, Nurcan BAYKAM, DERYA YAPAR, Selami EKİN, Mehmet POLATLI, Şebnem Eren GÖK, Oğuz KILINÇ, Abdullah SAYINER, Ömer KARAŞAHİN, Çağlar ÇUH

Impact of Non-surgical Periodontal Therapy on Pulmonary functions, Periodontal Health and Salivary Matrix Metalloproteinase-8 of COPD Patients with Chronic Periodontitis: A Clinico-biochemical Study

Sakshi SHARMA, Ajay Kumar VERMA, Abhaya GUPTA, Anjani PATHAK, Sheetal VERMA, Shyam Chand CHAUDHARY, Shalini KAUSHAL, Nand LAL, Surya KANT, Umesh Pratap VERMA

Management of Patients with Connective Tissue Disease-associated Interstitial Lung Diseases During the COVID-19 Pandemic

Canan GÜNDÜZ, Dilek KARADOĞAN, Furkan UFUK, Osman CÜRE, Göksel ALTINIŞIK