Assessment of Insulin Resistance in Patients with Chronic Obstructive Pulmonary Disease Attending a Tertiary Care Hospital

Abstract

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is increasingly recognized as a systemic inflammatory disorder with multiple extrapulmonary manifestations. Insulin resistance (IR) is one such metabolic abnormality that contributes to cardiovascular morbidity and poor outcomes in COPD patients. Aim: To assess insulin resistance in patients with COPD and to evaluate its association with disease severity. Materials and Methods: This hospital-based crosssectional study was conducted in a tertiary care hospital and included 100 participants: 50 clinically stable COPD patients diagnosed according to ATS/ERS guidelines and 50 age- and sex-matched healthy controls. Fasting blood glucose, fasting serum insulin, lipid profile parameters, and anthropometric measurements were recorded. Insulin resistance was assessed using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). Surrogate markers such as triglyceride-to-HDL ratio (TG:HDL) and triglyceride-glucose (TyG) index were also calculated. Pulmonary function tests were performed using spirometry. Statistical analysis was carried out using SPSS version 25, and a p-value <0.05 was considered statistically significant. Results: COPD patients had significantly higher fasting blood glucose, fasting insulin levels, HOMA-IR, TG:HDL ratio, and TyG index compared to controls (p<0.001). Insulin resistance showed a significant progressive increase with advancing stages of COPD. HOMA-IR demonstrated a strong association with disease severity. Conclusion: Insulin resistance is significantly increased in patients with COPD and correlates positively with disease severity. Early identification of metabolic abnormalities may help reduce long-term cardiovascular and metabolic complications in COPD patients.