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Abstract
Background Chronic obstructive pulmonary disease (COPD) is a multi-component systemic disease with elevated serum C-reactive protein (CRP) levels in stable conditions and during exacerbations. Serum CRP is an important biomarker and increased CRP levels lead to diminished lung function, decreased stamina to exercise, and poor quality of life in COPD patients. Aim This study aimed to determine the relationship between serum CRP levels and the impact of various risk factors and associated morbidities among patients with COPD attending a tertiary care hospital in Bhubaneswar. Methods 205 stable COPD patients were enrolled. The CRP levels were analyzed with reference to the patients’ sociodemographics, clinical profiles, symptoms, and risk factors. Results In our study, more males were enrolled. It was observed that most of them were in the age group of 51-60 years, residing in urban areas, and belonging to a lower socio-economic group living in houses with no proper ventilation. A significant proportion of COPD patients had exposure to smoke, biomass, or dust for 20 years or more. There was no significant difference in age distribution and socio-economic status across genders. Urban slums (p = 0.048), illiteracy (p < 0.0001), ventilation status (p = 0.0009), and exposure to tobacco, smokeless tobacco, dust, etc. (p < 0.00001), were significant factors. 73% of male and 59% of female COPD patients were taking both oral and inhaler medicines. The majority of COPD patients had normal BMI. Females had a higher prevalence of wheezing symptoms (p < 0.00001), obesity (BMI ≥ 30.0), pre-diabetes (p = 0.044), and diabetes (p = 0.0200). 13% of male COPD patients had hypertension. 55% of the COPD patients had 3-10 mg/L of serum CRP, and 81% were in stage 1, 12% in stage 2, and 6% in stage 3 (GOLD). No significant gender difference in GOLD stage, duration of COPD, medication type, and hospitalization rates was observed. A higher proportion of males exhibited night/morning cough and an FEV1/FVC ratio of less than 70% predicted value. The differences in CRP levels across stages were statistically significant. The findings have provided valuable insights into the inflammatory status of COPD patients based on CRP levels, varying symptomatology, and lung function impairment. Conclusion COPD patients, in general, have increased levels of CRP; this emphasizes the measurement of CRP in stable COPD patients.
Highlights
Chronic obstructive pulmonary disease (COPD) is a significant community health problem in several countries and is likely to be the fifth reason for debilitation and the third major reason for mortality worldwide by 2030
205 COPD patients diagnosed on the basis of the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) guidelines, history, clinical examination, and Pulmonary function tests (PFTs) results were included in the study Fig. (1)
A few needed nebulization and oxygen therapy upon first visit/admission, while corticosteroids were prescribed for inflammatory reactions. 73% (127) of male and 59% (19) of female COPD patients were taking both oral and inhaler medicines. 16% (28) of male and 28% (9) of female COPD patients were hospitalized for exacerbations
Summary
Chronic obstructive pulmonary disease (COPD) is a significant community health problem in several countries and is likely to be the fifth reason for debilitation and the third major reason for mortality worldwide by 2030. It caused 3.23 million deaths in 2019 [1-3]. Improving indoor and outdoor air quality can restrict the occurrence of COPD by decreasing exposure to risk factors. Serum CRP is an important biomarker and increased CRP levels lead to diminished lung function, decreased stamina to exercise, and poor quality of life in COPD patients
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