Correlation of BMI and serum albumin with c-reactive protein in male patients with stable chronic obstructive pulmonary disease

Pranab Mandal, Niranjan Sit, Abinash Agarwala, Aloke Gopal Ghoshal, Debasmita Bandyopadhyay


Background: There is growing consensus that chronic obstructive pulmonary disease (COPD), a chronic inflammatory disease of the airways and lung parenchyma is associated with low grade systemic inflammation even in stable COPD, which increases during acute exacerbation. It is still debated whether the inflammation is a spill-over from the lung or the lung bears the share of systemic inflammation in COPD. There is systemic manifestation in COPD which is responsible for its severity in individual cases, but it is not clearly known whether the systemic inflammation give rise to systemic manifestations.

Methods: In this background we measured serum C-reactive protein (CRP) level in 53 stable COPD patients and 32 age/sex matched control without known ischemic heart disease (IHD)/ diabetes mellitus (DM)/ peripheral arterial disease and normal chest X-ray and tried to find out any correlation of serum CRP level (marker of systemic inflammation) with BMI and serum albumin (marker of nutritional abnormality).

Results: The study found that serum CRP level was significantly higher in stable COPD patient in comparison to healthy control. (6.226±3.9 vs 1.31±0.53).

Though serum CRP level did not significantly increase with increasing severity of the disease, but serum CRP level was significantly increased in COPD patients with low BMI and low serum albumin (9.10±3.14 vs 4.01±2.90 p value <0.001 and 8.51±3.5 vs 3.59±2.5 with p value <0.001 respectively for BMI and serum albumin).

Conclusions: So, the study concluded that stable COPD is associated with increased systemic inflammatory markers than normal control, correlates significantly with nutritional parameters in COPD like BMI and serum albumin level and may be an indicator of malnutrition regardless of lung function impairment.


BMI, COPD, CRP, Systemic inflammation

Full Text:



Murray CJ, Lopez AD. Alternative projection of mortality and disability by cause.1990-2020. Global burden of disease study. Lancet. 1997;349(9064):1498-504.

Barnes PJ, Celli BR. Systemic manifestation and co-morbidities of COPD. Eur Respir J. 2009;33(5):1165-85.

Nussbaumer-Ochsner Y, Rabe KF. Systemic manifestations of COPD. Chest. 2011 Jan 1;139(1):165-73.

Agustí A. Systemic effects of chronic obstructive pulmonary disease: what we know and what we don't know (but should). Proceedings of the Am Thoracic Soc. 2007 Oct 1;4(7):522-5.

Sin DD, Man SF. why are patients with chronic obstructive pulmonary disease at increase risk of cardiovascular disease? The potential role of systemic inflammation in chronic obstructive pulmonary disease. Circulation. 2003;107:1514-9.

Yende S, Waterer GW, Tolley EA, Newman AB, Bauer DC, Taaffe DR, et al. Inflammatory markers are associated with ventilatory limitation and muscle dysfunction in obstructive lung disease in well functioning elderly subjects. Thorax. 2006 Jan 1;61(1):10-6.

Broekhuizen R, Wouters EF, Creutzberg EC, Schols AM. Raised CRP levels mark metabolic and functional impairment in advanced COPD. Thorax. 2006 Jan 1;61(1):17-22.

Njim J, Wikby A, Tompa A, Olsson AG, Jonasson L. Circulating levels of pro-inflammatory cytokines and neutrophill-platelet aggregates in patients with coronary artery disease. Am J Cardiol. 2005;95(4):452-6.

Gan WQ, Man SF, Senthilselvan A, Sin DD. Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis. Thorax. 2004 Jul 1;59(7):574-80.

Pinto-Plata VM, Müllerova H, Toso JF, Feudjo-Tepie M, Soriano JB, Vessey RS, et al. C-reactive protein in patients with COPD, control smokers and non-smokers. Thorax. 2006 Jan 1;61(1):23-8.

Dentener MA, Creutzberg EC, Schols AM, Mantovani A, van‘t Veer C, Buurman WA, et al. Systemic anti-inflammatory mediators in COPD: increase in soluble interleukin 1 receptor II during treatment of exacerbations. Thorax. 2001 Sep 1;56(9):721-6.

De Torres JP, Cordoba-Lanus E, Lopez-Aguilar C, de Fuentes MM, De Garcini AM, Aguirre-Jaime A, Celli BR, Casanova C. C-reactive protein levels and clinically important predictive outcomes in stable COPD patients. Euro Resp J. 2006;27:902-7.

Karadag F, Kirdar S, Karul AB, Ceylan E. The value of C-reactive protein as a marker of systemic inflammation in stable chronic obstructive pulmonary disease. Eur J Internal Med. 2008 Mar 1;19(2):104-8.

Schols AM, Buurman WA, Van den Brekel AS, Dentener MA, Wouters EF. Evidence for a relation between metabolic derangements and increased levels of inflammatory mediators in a subgroup of patients with chronic obstructive pulmonary disease. Thorax. 1996;51(8):819-24.