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CHRONIC OBSTRUCTIVE PULMONARY DISEASE |
1 The James Hogg iCAPTURE Center for Cardiovascular and Pulmonary Research, Vancouver, British Columbia, Canada
2 Department of Medicine (Pulmonary Division), University of British Columbia, Vancouver, British Columbia, Canada
3 Department of Medicine, Pulmonary Division, University of Alberta, Edmonton, Alberta, Canada
4 Department of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada
Correspondence to:
Correspondence to:
Dr D D Sin
James Hogg iCAPTURE Center for Cardiovascular and Pulmonary Research, St Paul’s Hospital, Room 368A, 1081 Burrard Street, Vancouver, BC, Canada V6A 1Y6; dsin{at}mrl.ubc.ca
Background: Individuals with chronic obstructive pulmonary disease (COPD) are at increased risk of cardiovascular diseases, osteoporosis, and muscle wasting. Systemic inflammation may be involved in the pathogenesis of these disorders. A study was undertaken to determine whether systemic inflammation is present in stable COPD.
Methods: A systematic review was conducted of studies which reported on the relationship between COPD, forced expiratory volume in 1 second (FEV1) or forced vital capacity (FVC), and levels of various systemic inflammatory markers: C-reactive protein (CRP), fibrinogen, leucocytes, tumour necrosis factor-
(TNF-), and interleukins 6 and 8. Where possible the results were pooled together to produce a summary estimate using a random or fixed effects model.
Results: Fourteen original studies were identified. Overall, the standardised mean difference in the CRP level between COPD and control subjects was 0.53 units (95% confidence interval (CI) 0.34 to 0.72). The standardised mean difference in the fibrinogen level was 0.47 units (95% CI 0.29 to 0.65). Circulating leucocytes were also higher in COPD than in control subjects (standardised mean difference 0.44 units (95% CI 0.20 to 0.67)), as were serum TNF- levels (standardised mean difference 0.59 units (95% CI 0.29 to 0.89)).
Conclusions: Reduced lung function is associated with increased levels of systemic inflammatory markers which may have important pathophysiological and therapeutic implications for subjects with stable COPD.
Abbreviations: COPD, chronic obstructive pulmonary disease; CRP, C-reactive protein; FEV1, forced expiratory volume in 1 second; IL, interleukin; TNF-, tumour necrosis factor-
Keywords: chronic obstructive pulmonary disease; inflammation; C-reactive protein; meta-analysis
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Thorax 2004 59: 545.
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