RACIAL DIFFERENCES IN COMORBIDITY PROFILES AMONG COPD PATIENTS WITH SMOKING HISTORY: COMPARISON DATA FROM THE KOCOSS AND COPDGENE STUDIES

Abstract

Background

Chronic obstructive pulmonary disease (COPD) associated comorbidities increase risk of acute exacerbations resulting in poor quality of life and high mortality. Tobacco smoking is a common risk factor for many comorbidities, including coronary heart disease, heart failure and lung cancer. The racial differences in comorbidity profile among COPD patients have been reported in general population, but there is limited data in COPD patients with history of tobacco smoking. This study aims to evaluate racial differences in comorbidity profiles among COPD patients with more than 10 pack-year history of smoking.

Methods

COPD patients aged 45 or older with at least 10 pack-year smoking history from The Korean COPD Subtype Study (KOCOSS) (n=1,772) and The Genetic Epidemiology of COPD (COPDGene) Study (3,461 non-Hispanic whites (NHW) and 1,016 African Americans (AA)) were analyzed to compare the prevalence of comorbidities by race. Comorbidities were assessed by self-reported questionnaire.

Results

Koreans were older (69.6 years) than NHW and AA (64.3 and 58.6 years, respectively) and had higher prevalence of males (97.2%) than NHW and AA (56.3% and 54.6%, P <0.01). The average body mass index (BMI) of NHW and AA was similar (27.9 kg/m2 for both), but Koreans had significantly lower BMI (22.4 kg/m2, P <0.01). SGRQ total score was highest among AA (40.1.), followed by NHW (35.9), and Koreans (35.3, P <0.01). Compared to NHW, AA and Koreans had significantly increased adjusted prevalence ratios (aPRs) of diabetes mellitus (1.63 and 1.58) and decreased aPRs of dyslipidaemia (0.80 and 0.23), gastro-oesophageal reflux disease (0.64 and 0.34), and osteoporosis (0.48 and 0.38). Compared to NHW, Koreans had decreased aPRs of hypertension (0.79), myocardial infarction (0.44) and peripheral vascular disease (0.34).

Conclusions

COPD-related comorbidities varied significantly by race among patients with smoking history. Different strategies may be required for the optimal management of COPD and its comorbidities in different race.