Identification of chronic obstructive pulmonary disease subgroups in 13 Asian cities

Kim WJ 1 , Gupta V 2 , Nishimura M 3 , Makita H 3 , Idolor L 4 , Roa C 5 Show all authors , Loh LC 6 , Ong CK 6 , Wang JS 7 , Boonsawat W 8 , Gunasekera KD 9 , Madegedara D 10 , Kuo HP 11 , Wang CH 11 , Wang C 12 , Yang T 12 , Lin YX 13 , Ko FWS 14 , Hui DSC 14 , Lan LTT 15 , Vu QTT 15 , Bhome AB 16 , Ng A 17 , Seo JB 18 , Lee BY 19 , Lee JS 20 , Oh YM 20 , Lee SD 20

Affiliations 

  • 1 Department of Internal Medicine, Kangwon National University, Chuncheon, Korea
  • 2 Department of Internal Medicine, Kangwon National University, Chuncheon, Korea, Adesh Institute of Medical Sciences and Research, Bathinda, India
  • 3 Division of Respiratory Medicine, Department of Internal Medicine, Hokkaido University Hospital, Sapporo, Japan
  • 4 Section of Respiratory Services and Physical Therapy and Rehabilitation Lung Center of the Philippines, Quezon City
  • 5 College of Medicine and Philippine General Hospital, University of the Philippines, Manila, The Philippines
  • 6 Department of Medicine, Penang Medical College, Penang, Malaysia
  • 7 Taipei Medical University, Taipei, Taiwan
  • 8 Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
  • 9 Central Chest Clinic, National Hospital of Sri Lanka, Colombo
  • 10 Respiratory Disease Treatment Unit, Teaching Hospital Kandy, Kandy, Sri Lanka
  • 11 Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan
  • 12 Department of Respiratory and Critical Care Medicine, Beijing China-Japan Friendship Hospital, Beijing
  • 13 Beijing Institute of Respiratory Medicine, Department of Respiratory and Critical Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing
  • 14 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
  • 15 Respiratory Care Center, University Medical Center, Ho Chi Minh City, Viet Nam
  • 16 Indian Coalition of Obstructive Lung Diseases Network, Pune, Maharashtra, India
  • 17 Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore
  • 18 Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul
  • 19 Division of Allergy and Respiratory Diseases, Soon Chun Hyang University Hospital, Seoul
  • 20 Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Int J Tuberc Lung Dis, 2018 07 01;22(7):820-826.
PMID: 29914609 DOI: 10.5588/ijtld.17.0524

Abstract

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a heterogeneous condition that can differ in its clinical manifestation, structural changes and response to treatment.

OBJECTIVE: To identify subgroups of COPD with distinct phenotypes, evaluate the distribution of phenotypes in four related regions and calculate the 1-year change in lung function and quality of life according to subgroup.

METHODS: Using clinical characteristics, we performed factor analysis and hierarchical cluster analysis in a cohort of 1676 COPD patients from 13 Asian cities. We compared the 1-year change in forced expiratory volume in one second (FEV1), modified Medical Research Council dyspnoea scale score, St George's Respiratory Questionnaire (SGRQ) score and exacerbations according to subgroup derived from cluster analysis.

RESULTS: Factor analysis revealed that body mass index, Charlson comorbidity index, SGRQ total score and FEV1 were principal factors. Using these four factors, cluster analysis identified three distinct subgroups with differing disease severity and symptoms. Among the three subgroups, patients in subgroup 2 (severe disease and more symptoms) had the most frequent exacerbations, most rapid FEV1 decline and greatest decline in SGRQ total score.

CONCLUSION: Three subgroups with differing severities and symptoms were identified in Asian COPD subjects.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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