• Filip J J Triest, FranssenFrits M EFME0000-0002-1633-6356CIRO+, Centre of Expertise for Chronic Organ Failure, 6085 NM Horn, The Netherlands. fritsfranssen@ciro-horn.nl.Department of Respiratory Medicine, MUMC+, Maastricht University Medical Centre, 6229 ER Maastricht, The, Niki Reynaert, Swetlana Gaffron, Martijn A Spruit, JanssenDaisy J ADJACIRO+, Centre of Expertise for Chronic Organ Failure, 6085 NM Horn, The Netherlands. daisyjanssen@ciro-horn.nl., RuttenErica P AEPACIRO+, Centre of Expertise for Chronic Organ Failure, 6085 NM Horn, The Netherlands. ericarutten07@gmail.com., WoutersEmiel F MEFMCIRO+, Centre of Expertise for Chronic Organ Failure, 6085 NM Horn, The Netherlands. e.wouters@mumc.nl.Department of Respiratory Medicine, MUMC+, Maastricht University Medical Centre, 6229 ER Maastricht, The Netherlands. e.wouters@mumc., and VanfleterenLowie E G WLEGWCIRO+, Centre of Expertise for Chronic Organ Failure, 6085 NM Horn, The Netherlands. lowievanfleteren@ciro-horn.nl.Department of Respiratory Medicine, MUMC+, Maastricht University Medical Centre, 6229 ER Maastricht, The Netherlan.
• CIRO+, Centre of Expertise for Chronic Organ Failure, 6085 NM Horn, The Netherlands. filiptriest@hotmail.com.
• J Clin Med. 2019 Apr 14; 8 (4).

BackgroundPatients with chronic obstructive pulmonary disease (COPD) often suffer from multiple morbidities, which occur in clusters and are sometimes related to accelerated aging. This study aimed to assess the disease specificity of comorbidity clusters in COPD and their association with a biomarker of accelerated aging as a potential mechanistic factor.MethodsBody composition, metabolic, cardiovascular, musculoskeletal, and psychological morbidities were objectively evaluated in 208 COPD patients (age 62 ± 7 years, 58% males, FEV1 50 ± 16% predicted) and 200 non-COPD controls (age 61 ± 7 years, 45% males). Based on their presence and severity, the morbidities were clustered to generate distinct clusters in COPD and controls. Telomere length in circulating leukocytes was compared across the clusters.Results(co)morbidities were more prevalent in COPD patients compared to controls (3.9 ± 1.7 vs. 2.4 ± 1.5, p < 0.05). A "Psychologic" and "Cachectic" cluster were only present in the COPD population. "Less (co)morbidity", "Cardiovascular", and "Metabolic" clusters were also observed in controls, although with less complexity. Telomere length was reduced in COPD patients, but did not differ between the (co)morbidity clusters in both populations.ConclusionsTwo COPD-specific comorbidity clusters, a "Cachectic" and "Psychologic" cluster, were identified and warrant further studies regarding their development. Accelerated aging was present across various multimorbidity clusters in COPD.

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