Introduction

The chronic obstructive pulmonary disease (COPD) is a chronic disease of the respiratory
system characterized by a persistent and irreversible airway obstruction associated with
chronic inflammation of the airways and the systemic circulation. The disease is worsening
and it is characterized by a tendency to exacerbate with several comorbidities. The WHO
estimates that it will become the third leading cause of death in 2020.
Reference :
Terzano C.,Romani S., Gaudio C., et al. Right Heart Functional Changes in the Acute,
Hypercapnic Exacerbations of COPD, BioMed Research International, Vol. 2014, 1-6.
COPD is one of the most important causes of death in most countries. Actually, the mortality
of COPD increased from 1970 through 2002 in the United States though the mortality of
other diseases declined. Respiratory failure is considered the major cause of death in
advanced COPD, but comorbidities such as cardiovascular diseases and lung cancer are also
major causes of death in mild-to-moderate COPD.
Patients with COPD have been reported to have a higher prevalence of certain comorbid
conditions including ischemic heart disease, congestive heart failure, lung cancer ,
depression, osteoporosis , hypertension and diabetes mellitus , and have an average of 3.7
chronic medical conditions, compared with 1.8 chronic medical conditions for patients
without COPD. Ischemic heart disease, hypertension and lung cancer are classified as
common pathway comorbidities, which are the diseases with a common pathophysiology as,
for example, smoking related diseases. Congestive heart failure is classified as a complicating comorbidity since it is a condition that arises as a complication of COPD. The
presence of these diseases might affect the treatment and prognosis of COPD. In con- trast,
depression, osteoporosis and diabetes mellitus are clas- sified as co-incidental comorbidities,
which are coexisting chronic conditions with unrelated pathogenesis. The presence of these
diseases might become a useful indicator for early detection of COPD. However, the number
of the patients with liver diseases was small, and the details of the liver diseases were not
clearly investigated, though an interaction between hepatitis virus and the reduction of forced
expiratory volume in one second (FEV1) has been reported. In this study, we investigated the
prevalence of COPD in patients with liver diseases by recruiting a large number of patients,
and also investigated the effects of hepatitis virus on the COPD prevalence.

Reference:
Minakata Y., Ueda H., Akamatsu K et al. High COPD Prevalence in Patients with Liver
Disease. Intern Med, vol. 49. 2010, 2687-2691.