Prospective evaluation of cardio-metabolic comorbidities in a cohort of patients with non-cystic fibrosis bronchiectasis

Introduction: Bronchiectasis is associated with airway and systemic inflammation, and chronic or repeated hypoxemia. Both could increase comorbid prevalence of cardiovascular diseases (CVD), osteoporosis and sarcopenia. Methods: A monocentric, prospective study on adults with bronchiectasis, excluding cystic fibrosis, was conducted. CVD, osteoporosis and sarcopenia prevalence were assessed on medical record, double questioning and then screened with a blood test, a transthoracic echocardiography, an EKG, a bone mineral density, aortic pulse wave velocity density and skeletal muscle mass measurement. Association between comorbidities and bronchiectasis severity was explored. Then, this cohort was compared to COPD patients or smokers and non-smokers without respiratory disease. Results: 89 patients were included. (63 women, 37 smokers). Bacterial airway colonization rate was 22%. Median FEV 1 was 84% [IQR 66-99%]. According to Bronchectasis Severity Index (BSI), most of patients had mild (43%) and moderate (35%) bronchiectasis. CVD, osteoporosis and sarcopenia prevalence were respectively 24%, 33% and 25%. CVD and osteoporosis were not associated with bronchiectasis severity (respectively p=0,727 and p=0,053). Osteoporosis and sarcopenia were more frequent in bronchiectasis than in non-smokers respiratory disease-free patients (p=0,005 and p=0,009). Prevalence of both diseases wasn’t different between bronchiectasis and COPD groups (p=0,078 and p=0,556). Conclusion: In our cohort of patients with bronchiectasis, prevalence of osteoporosis and sarcopenia, whatever disease’s severity, is high and might lead to specific screening and prevention strategies.