Obesity, Charlson comorbidity index, and neutrophil-to-lymphocyte ratio in chronic obstructive pulmonary disease: relationship to disease severity

Bratisl Lek Listy. 2023;124(7):520-526. doi: 10.4149/BLL_2023_080.

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a common chronic inflammatory lung disease with high mortality and morbidity rates. Obesity, various comorbid diseases, and inflammation often coexist in chronic obstructive pulmonary disease (COPD), exhibiting a complex interaction with disease severity. The aim of the study was to examine the relationship between COPD markers and obesity, the Charlson Comorbidity Index (CCI), and neutrophil/lymphocyte ratio (NLR).

Methods: Eighty male patients with stable COPD admitted to the pulmonology unit were included in the study. The presence of comorbidities was investigated in obese and non-obese individuals with COPD. Pulmonary function tests and the mMRC dyspnea scale were examined, and CCI scores were calculated.

Results: 60.9 % with mild/moderate COPD, and 64.7 % with severe COPD had a comorbid disease. The incidence of hypertension and diabetes was significantly higher in obese patients. The obesity rate was 41.3 % in patients with mild/moderate COPD (FEV1 ≥ 50) and 26.5 % in those with severe COPD (FEV1 < 50). There was a positive and significant correlation between CCI value and BMI and mMRC dyspnea scale. NLR was significantly higher in patients with FEV1 < 50 and mMRC ≥ 2.

Conclusions: As a result, it is essential to screen obese patients with COPD, who are among the groups with the highest incidence of comorbidities, in terms of such diseases that exacerbate the symptoms of their disease. Findings may support the potential applicability of simple blood count indices (such as NLR) in the clinical assessment of disease in stable COPD patients (Tab. 4, Fig. 1, Ref. 46).

Keywords: COPD; Charlson comorbidity index; inflammation neutrophil-to-lymphocyte ratio.; obesity.

MeSH terms

  • Comorbidity
  • Dyspnea
  • Humans
  • Lymphocytes
  • Male
  • Neutrophils*
  • Obesity / complications
  • Obesity / epidemiology
  • Patient Acuity
  • Pulmonary Disease, Chronic Obstructive* / complications
  • Pulmonary Disease, Chronic Obstructive* / epidemiology
  • Severity of Illness Index