TY - JOUR
T1 - Inflammatory biomarkers and comorbidities in chronic obstructive pulmonary disease
AU - Thomsen, Mette
AU - Dahl, Morten
AU - Lange, Peter
AU - Vestbo, Jørgen
AU - Nordestgaard, Børge G.
PY - 2012/11/15
Y1 - 2012/11/15
N2 - Rationale: Patients with chronic obstructive pulmonary disease (COPD) have evidence of systemic inflammation that may be implicated in the development of comorbidities. Objectives: To test the hypothesis that elevated levels of three inflammatory biomarkers are associated with increased risk of comorbidities in COPD. Methods:We examined 8,656 patients withCOPDfrom two large Danish population studies andduringa median 5 years' follow-up recorded hospital admissions due to major comorbidities as endpoints. Measurements and Main Results: We measured baseline C-reactive protein (CRP), fibrinogen,and leukocyte count,andrecorded admissions due to ischemic heart disease, myocardial infarction, heart failure, type II diabetes, lung cancer, pneumonia, pulmonary embolism, hip fracture, and depression for all participants. Multifactorially adjusted risk of ischemic heart disease was increased by a factor of 2.19 (95% confidence interval, 1.48-3.23) in individuals with three biomarkers elevated (CRP > 3mg/L, fibrinogen > 14 mmol/L, and leukocyte count > 9×109/L) versus individuals with all three biomarkers at or below these limits. Corresponding hazard ratios were 2.32 (1.34-4.04) formyocardial infarction, 2.63 (1.71-4.04) for heart failure, 3.54 (2.03-6.19) for diabetes, 4.00 (2.12-7.54) for lung cancer, and 2.71 (2.03-3.63) forpneumonia.Therewerenoconsistentdifferences in risk of pulmonary embolism, hip fracture, or depression as a function of these three biomarkers. Conclusions: Simultaneously elevated levels of CRP, fibrinogen, and leukocyte count are associated with a two-to four fold increased risk of major comorbidities in COPD. These biomarkersmay be an additional tool for clinicians to conduct stratified management of comorbidities in COPD.
AB - Rationale: Patients with chronic obstructive pulmonary disease (COPD) have evidence of systemic inflammation that may be implicated in the development of comorbidities. Objectives: To test the hypothesis that elevated levels of three inflammatory biomarkers are associated with increased risk of comorbidities in COPD. Methods:We examined 8,656 patients withCOPDfrom two large Danish population studies andduringa median 5 years' follow-up recorded hospital admissions due to major comorbidities as endpoints. Measurements and Main Results: We measured baseline C-reactive protein (CRP), fibrinogen,and leukocyte count,andrecorded admissions due to ischemic heart disease, myocardial infarction, heart failure, type II diabetes, lung cancer, pneumonia, pulmonary embolism, hip fracture, and depression for all participants. Multifactorially adjusted risk of ischemic heart disease was increased by a factor of 2.19 (95% confidence interval, 1.48-3.23) in individuals with three biomarkers elevated (CRP > 3mg/L, fibrinogen > 14 mmol/L, and leukocyte count > 9×109/L) versus individuals with all three biomarkers at or below these limits. Corresponding hazard ratios were 2.32 (1.34-4.04) formyocardial infarction, 2.63 (1.71-4.04) for heart failure, 3.54 (2.03-6.19) for diabetes, 4.00 (2.12-7.54) for lung cancer, and 2.71 (2.03-3.63) forpneumonia.Therewerenoconsistentdifferences in risk of pulmonary embolism, hip fracture, or depression as a function of these three biomarkers. Conclusions: Simultaneously elevated levels of CRP, fibrinogen, and leukocyte count are associated with a two-to four fold increased risk of major comorbidities in COPD. These biomarkersmay be an additional tool for clinicians to conduct stratified management of comorbidities in COPD.
KW - Biomarkers
KW - Chronic obstructive pulmonary disease
KW - Comorbidities
KW - Inflammation
UR - http://www.scopus.com/inward/record.url?scp=84869223241&partnerID=8YFLogxK
U2 - 10.1164/rccm.201206-1113OC
DO - 10.1164/rccm.201206-1113OC
M3 - Article
C2 - 22983959
AN - SCOPUS:84869223241
VL - 186
SP - 982
EP - 988
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
SN - 1073-449X
IS - 10
ER -