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CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN THE NON-
SMOKER PATIENTS: WHAT FEATURES SHOULD BE KNOWN?

K. DERBEL, A. SAYHI, B. BARKOUS, S. KHALDI, F. GUEZGUEZ, S. ROUATBI
1- DEPARTMENT OF PHYSIOLOGY AND FUNCTIONAL EXPLORATIONS, FARHAT HACHED HOSPITAL,
SOUSSE- TUNISIA
2- RESEARCH LABORATORY, LR12SP09

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is considered as a
major public health problem due to its prevalence and socio-economic impact. It is
most commonly caused by tobacco smoking. Nevertheless, the non- smokers'
proportion among the COPD patients is not neglectable.

Objective: Determine the anthropometric, clinical, and respiratory functional profiles
of non-smoker patients with COPD (COPD-NS) and to compare them with those of
smokers with similar disease (COPD-S).

METHODS: This was a cross-sectional study of 160 patients (127 males and 33
females). The definition of COPD was based on spirometric criterion (GOLD). The
study subjects were divided into 2 groups according to their smoking status: group 1:
NS-COPD and group 2: S-COPD. They answered a medical questionnaire and
underwent pre- and post-bronchodilator spirometry with measurement of the Forced
expiratory volume in one second (FEV1), the Forced vital capacity (FVC), the ratio
FEV1/CVF and the Forced Expiratory Flow (FEF25-75%). An analysis of all
anthropometric and spirometric data was performed using SPSS software.

RESULTS : The means ± standard deviation of the total sample of age (years), height
(m), weight (Kg), Body Mass Index (Kg/m²), FEV1 (L), FVC (L), FEV1/FVC ratio, FEF25-
75%(L/s) pre- and post-bronchodilator (BD) were 57±15.6, 1.67±0.1, 71±15, 25.7±06,
1.52±0.71, 2.7±1.06, 0.55±0.1, 0.84±0.56, 1.8±0.82, 3.07±1.14, 0.57±0.1 and 1±0.6
respectively. Among the 47 NS-COPD patients, 32 were female and 15 were male.

A comparison of the two study groups was performed using the t-student test
(p<0.05), which showed significant differences regarding anthropometric
characteristics (height and BMI), respiratory functional data (pre- and post-BD
FEV1/FVC ratios) and severity of proximal obstructive ventilatory defect (POVD). NS-
COPD patients had greater body mass index and significantly higher FEV1/FVC pre-
and post-BD ratios than were the S- COPD. The severity of COPD was significantly
more marked in the S-COPD patients. NS-COPD patients had significantly fewer
respiratory functional complaints. Weights, as well as distal expiratory flows (FEF25-
75% pre- and post BD) were comparable between both groups.

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