Association Between Routine Blood Biomarkers and Clinical Phenotypes and Exacerbations in Chronic Obstructive Pulmonary Disease
Núñez, Alexa (Universitat Autònoma de Barcelona. Departament de Medicina)
Marras, Viviana (Respiratory Unit, AOU Sassari)
Harlander, Matevz (University Medical Centre Ljubljana)
Mekov, Evgeni (Medical University of Sofia)
Esquinas, Cristina (Hospital Universitari Vall d'Hebron)
Turel, Matjaz (University Medical Centre Ljubljana)
Lestan, David (University Medical Centre Ljubljana)
Petkov, Rosen (Medical University of Sofia)
Yanev, Nikolay (Medical University of Sofia)
Pirina, Pietro (Respiratory Unit, AOU Sassari)
Negri, Silvia (Respiratory Unit, AOU Sassari)
Miravitlles, Marc (Universitat Autònoma de Barcelona. Departament de Medicina)
Barrecheguren, Miriam (Hospital Universitari Vall d'Hebron)

Data:	2020
Resum:	Chronic obstructive pulmonary disease (COPD) is associated with increased lung and systemic inflammation. We aimed to identify associations between easy-to-obtain blood biomarkers and the frequency and severity of exacerbations. Cross-sectional, multicentre study performed in four centres in Spain, Italy, Bulgaria, and Slovenia. Blood samples were obtained for blood cell count, C-reactive protein (CRP), alpha-1 antitrypsin (AAT) and fibrinogen analysis. The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and eosinophil/basophil ratio (EBR) were calculated. Firstly, patients were divided into clinical phenotypes according to the Spanish guidelines of COPD, and secondly, patients were classified into 2 groups: non-exacerbators (≤1 ambulatory exacerbation in the previous year) and exacerbators (≥2 ambulatory exacerbations or 1 hospitalisation in the previous year). A multivariate stepwise logistic regression model was performed to identify laboratory parameters associated with exacerbators. A total of 355 patients with a mean age 66 years (SD=8. 9) were included, and 64% were male. The mean FEV1% (forced expiratory volume in the first second) was 55% (SD=20%), and the mean COPD Assessment Test (CAT) score was 15. 6 (SD=7. 9). One hundred ninety-six (55. 2%) patients were classified in the non-exacerbator group, and 159 (44. 8%) were exacerbators. Patients in the exacerbators group presented lower haemoglobin levels (p=0. 019) and ERB (p= 0. 023) but higher CRP levels (p=0. 001). In the multivariate analysis, females, higher levels of CRP, lower FEV1% and low EBR were independently related to exacerbators. Female sex, having a more severe impairment of lung function, higher CRP levels and a lower EBR are associated with an exacerbator phenotype in COPD.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	COPD ; Blood cells ; Biomarkers ; Exacerbation ; Phenotypes
Publicat a:	International journal of COPD, Vol. 15 (march 2020) , p. 681-690, ISSN 1178-2005

DOI: 10.2147/COPD.S240720
PMID: 32280207

10 p, 685.5 KB

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