Affiliation:
1. Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases
(NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
2. Tracheal Diseases Research Center,
National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences,
Tehran, Iran
Abstract
Background:
Chronic obstructive pulmonary disease (COPD) is related to oxidant/antioxidant
imbalance and systemic inflammation.
Objective:
This study was conducted to evaluate associations of serum levels of C-reactive protein
(CRP) and malondialdehyde (MDA) with the severity and exacerbations of COPD.
Methods:
A matched case-control study was performed among 200 COPD patients (100 cases and
100 controls) who were referred to Masih Daneshvari Hospital in Tehran, Iran. Cases were exacerbators
with equal to or greater than two ambulatory exacerbations or one hospitalization; controls
were non-exacerbators who had one/no ambulatory exacerbation during the preceding 12 months.
Blood samples were collected for CRP, MDA, and erythrocyte sedimentation rate (ESR) analysis.
In addition, spirometry, the COPD assessment test (CAT) score, the modified Medical Research
Council (mMRC) dyspnea scale, and the BODEx index were applied.
Results:
The mean (SD) age of the patients was 65.31 (8.46) years. Those with exacerbations had
significantly lower FEV1 and higher CRP, MDA, ESR, BMI, BODEx index, CAT, and mMRC
scores compared to non-exacerbators. There were significant differences in CRP, MDA, ESR,
FVC, FEV1, FEV1/FVC, BMI, BODEx index, mMRC, and CAT scores between the GOLD
group. Moreover, multivariate analysis showed that higher levels of CRP (OR=0.61, p=0.023),
MDA (OR=0.28, p=0.001), ESR (OR=0.86, p=0.029), CAT score (OR=0.84, p=0.012), BODEx index
(OR=0.89, p <0.001), BMI (OR=0.42, p <0.001), and lower FEV1% (OR=0.77, p <0.001)
were independent risk factors for frequent exacerbations.
Conclusion:
In conclusion, elevated serum MDA and CRP levels in combination may serve as
prognostic indicators of the severity and exacerbation of COPD.
Publisher
Bentham Science Publishers Ltd.
Subject
Pulmonary and Respiratory Medicine