Clinical and Radiological Features Between Patients with Stable COPD from Plateau and Flatlands: A Comparative Study

Abstract

Zhihan Jiang,1,* Xiaosen Wang,1,* Lijiao Zhang,1,* Drolma Yangzom,2,* Yanping Ning,2 Baiyan Su,3,4 Meijiao Li,5 Meilang ChuTso,2 Yahong Chen,1,6 Ying Liang,1,2,6 Yongchang Sun1,6 1Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, Tibet Autonomous Region People’s Hospital, Lhasa, 850000, People’s Republic of China; 3Radiology Department, Peking Union Medical College Hospital, Beijing, 100730, People’s Republic of China; 4Radiology Department, Tibet Autonomous Region People’s Hospital, Lhasa, 850000, People’s Republic of China; 5Radiology Department, Peking University Third Hospital, Beijing, 100191, People’s Republic of China; 6Research Center for Chronic Airway Diseases, Peking University Health Science Center, Beijing, 100083, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ying Liang; Yongchang Sun, Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, North Garden Road 49, Haidian District, Beijing, People’s Republic of China, Tel [phone], Email [email protected]; [email protected]: COPD patients living in Tibet are exposed to specific environments and different risk factors and probably have different characteristics of COPD from those living in flatlands. We aimed to describe the distinction between stable COPD patients permanently residing at the Tibet plateau and those in flatlands.Methods: We conducted an observational cross-sectional study that enrolled stable COPD patients from Tibet Autonomous Region People’s Hospital (Plateau Group) and Peking University Third Hospital (Flatland Group), respectively. Their demographic information, clinical features, spirometry test, blood routine and high-resolution chest CT were collected and evaluated.Results: A total of 182 stable COPD patients (82 from plateau and 100 from flatland) were consecutively enrolled. Compared to those in flatlands, patients in plateau had a higher proportion of females, more biomass fuel use and less tobacco exposure. CAT score and frequency of exacerbation in the past year were higher in plateau patients. The blood eosinophil count was lower in plateau patients, with fewer patients having an eosinophil count ≥ 300/μL. On CT examination, the proportions of previous pulmonary tuberculosis and bronchiectasis were higher in plateau patients, but emphysema was less common and milder. The ratio of diameters of pulmonary artery to aorta ≥ 1 was more often in plateau patients.Conclusion: Patients with COPD living at Tibet Plateau had a heavier respiratory burden, lower blood eosinophil count, less emphysema but more bronchiectasis and pulmonary hypertension. Biomass exposure and previous tuberculosis were more common in these patients.Keywords: chronic obstructive pulmonary disease, plateau, phenotype, computed tomography, emphysema

Keywords

• chronic obstructive pulmonary disease
• plateau
• phenotype
• computed tomography
• emphysema