Arora Sneh, Madan Karan, Mohan Anant, Kalaivani Mani, Guleria Randeep
Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India.
Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
Lung India. 2019 Sep-Oct;36(5):393-398. doi: 10.4103/lungindia.lungindia_494_18.
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.
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).
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, 20.33 ± 0.62 kg/m, and 18.86 ± 0.52 kg/m, 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.
Patients with increasing severity of COPD had a significantly greater serum inflammatory marker level and poorer nutritional status.
慢性阻塞性肺疾病（COPD）是一种全身性炎症性疾病。我们研究了血清炎症标志物、C反应蛋白（CRP）、瘦素以及营养状况（通过测定血清前白蛋白水平和人体测量学评估）是否与COPD严重程度相关。
招募了102例COPD患者（平均年龄56.94±10.95岁），并根据GOLD指南将其分为不同严重程度类别。测定血清CRP、前白蛋白和瘦素浓度。人体测量学指标包括体重指数（BMI）、上臂中部周长（MUAC）以及四个皮褶厚度之和（肱三头肌、肱二头肌、髂嵴上和肩胛下）。
21例患者为中度COPD，44例为重度，37例为极重度。中度、重度和极重度COPD患者的CRP水平（mg/dl）（均值±标准误[SE]）分别为0.60±0.096、2.16±0.39和4.15±0.463。中度、重度和极重度COPD患者的前白蛋白水平（mg/dl）（均值±SE）分别为15.73±0.92、10.95±0.85和11.15±0.79mg/dl。中度、重度和极重度COPD患者的瘦素水平（ng/ml）（均值±SE）分别为13.81±3.88、8.45±2.25和4.40±1.06。三组的BMI值分别为23.44±1.16kg/m²、20.33±0.62kg/m²和18.86±0.52kg/m²。与中度和重度组相比，极重度组的四个皮褶厚度之和和MUAC显著降低。极重度COPD患者的瘦素、BMI和6分钟步行试验结果显著更低。极重度COPD患者的血清CRP显著更高。
COPD严重程度增加的患者血清炎症标志物水平显著更高，营养状况更差。
