RESUMO
BACKGROUND: As exacerbations of chronic obstructive pulmonary disease (COPD) are one of the leading causes of hospitalization and are associated with significant mortality, it is particularly important to accurately assess the risk of exacerbations in COPD. Most of the current clinical biomarkers are related to inflammation and few consider how ion levels affect COPD. Chloride ion, the second most abundant serum electrolyte, has been shown to be associated with poor prognoses in several diseases, but their relationship with COPD remains unclear. METHODS: In total, 105 patients with acute exacerbations of COPD were recruited. Data on clinical characteristics, lung function, blood count, blood biochemistry, relevant scales including the Clinical COPD Questionnaire (CCQ), BODE (BMI, airflow obstruction, dyspnea, exercise capacity) index and the St. George's Respiratory Questionnaire (SGRQ) were collected from all patients for statistical analysis. RESULT: There were significant differences in lung function indicators and disease severity in the low chloride ion subgroup compared with the high chloride ion subgroup. On multiple logistic regression analysis, chloride ion was an independent factor affecting lung function in COPD patients (OR = 0.808, 95% CI: 0.708 - 0.922, p = 0.002). The sensitivity of chloride ion in predicting COPD severity was 78%, the specificity was 63%, and the area under the curve was 0.734 (p < 0.001). Subgroup analysis showed that chloride ion was a stronger predictor in male and smoking patients. CONCLUSIONS: Chloride ion was a novel prognostic biomarker for COPD, and low levels of chloride ion were independently associated with exacerbations in COPD patients.
RESUMO
Background: Chronic Obstructive Pulmonary Disease (COPD) has been a concern all over the world because of its high prevalence and mortality. The ratio of low-density-lipoprotein to lymphocyte (LLR) has been widely used to predict the prognosis of cerebral infarction, but its association with COPD is less known. We aim to explore the relationship between LLR and COPD and to investigate its indicative role in the severity and prognosis of COPD. Methods: In this study, 279 participants (n = 138 with COPD and n = 138 age- and sex-matched health control) were recruited. COPD patients were divided into two groups according to the optimal cut-off value of LLR determined by the receiver operating characteristic curve (ROC). We collected the clinical characteristics, pulmonary function, LLR, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and other data of all subjects. t-test, Pearson correlation test, logistic regression analysis and other statistical analysis were carried out. Results: Compared with the healthy control group, COPD patients had a significantly higher LLR level (p < 0.001). The disease was more serious in the high LLR group, which was reflected by Global Initiative for Chronic Obstructive Lung Disease (GOLD) and BMI, airway obstruction, dyspnoea, severe exacerbations (BODE) index and St. George's Respiratory Questionnaire (SGRQ) index (p = 0.001, p = 0.013, p = 0.011, respectively). The forced expiration volume in 1 second (FEV1) (p = 0.033) and forced expiratory volume in 1 second in percent of the predicted value (FEV1%) (p = 0.009) in high LLR group were lower. Univariate and multivariate logistic regression analysis showed that LLR was an independent factor affecting the severity of COPD patients (odds ratio [OR] = 2.599, 95% CI: 1.266-5.337, p = 0.009). Conclusion: We found that LLR is a novel biomarker in predicting the severity of patients with COPD. Further studies with larger database were recommended to verify our findings.
