Serum inflammatory markers and nutritional status in patients with stable chronic obstructive pulmonary disease

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a systemic inflammatory disease. We investigated whether serum inflammatory markers, C-reactive protein (CRP), leptin, and nutritional status (assessed by measurement of serum levels of prealbumin and anthropometry) correlated with COPD severity. MATERIALS AND METHODS: One-hundred and two COPD patients (mean age 56.94 ± 10.95 years) were recruited and classified into severity categories based on the GOLD guidelines. Serum concentrations of CRP, prealbumin, and leptin were measured. Anthropometry included body mass index (BMI), mid-upper arm circumference (MUAC), and sum of four skinfold thicknesses (triceps, biceps, suprailiac, and subscapular). RESULTS: Twenty-one patients had moderate, 44 had severe, and 37 had very severe COPD. Levels of CRP (mg/dl) (mean ± standard error [SE]) in moderate, severe, and very severe COPD were 0.60 ± 0.096, 2.16 ± 0.39, and 4.15 ± 0.463, respectively. Levels of prealbumin (mg/dl) (mean ± SE) in moderate, severe, and very severe COPD were 15.7 3 ± 0.92, 10.95 ± 0.85, and 11.15 ± 0.79 mg/dl, respectively. Levels of leptin (ng/ml) (mean ± SE) in moderate, severe, and very severe COPD were 13.81 ± 3.88, 8.45 ± 2.25, and 4.40 ± 1.06, respectively. BMI values in the three groups were 23.44 ± 1.16 kg/m(2), 20.33 ± 0.62 kg/m(2), and 18.86 ± 0.52 kg/m(2), respectively. Sum of four skinfold thickness and MUAC was significantly reduced in very severe group as compared to moderate and severe group. Very severe COPD patients had a significantly lower leptin, BMI, and 6-min walk test. Serum CRP was significantly higher in very severe COPD. CONCLUSION: Patients with increasing severity of COPD had a significantly greater serum inflammatory marker level and poorer nutritional status.