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Chronic obstructive pulmonary disease
Plasma markers of inflammation and incidence of hospitalisations for COPD: results from a population-based cohort study
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  1. G Engström1,2,
  2. N Segelstorm1,
  3. M Ekberg-Aronsson1,
  4. P M Nilsson1,
  5. F Lindgärde1,
  6. C-G Löfdahl1
  1. 1
    Department of Clinical Sciences, University of Lund, Malmö and Lund, Sweden
  2. 2
    AstraZeneca R&D, Lund, Sweden
  1. Professor G Engström, Cardiovascular Epidemiology Research Group, CRC, Malmö University Hospital, S-20502 Malmö, Sweden; Gunnar.Engstrom{at}med.lu.se

Abstract

Background: The relationship between plasma markers of inflammation and the incidence of chronic obstructive pulmonary disease (COPD) is still unclear. This population-based study explored whether raised levels of five inflammation-sensitive plasma proteins (ISPs) predicted hospital admissions for COPD during 25 years of follow-up.

Methods: Spirometric tests and measurements of five ISPs (fibrinogen, ceruloplasmin, α1-antitrypsin, haptoglobin, orosomucoid) were performed in 5247 apparently healthy men from the city of Malmö (mean age 46 years). The incidence of hospitalisations for COPD was studied in relation to the number of ISPs in the fourth quartile.

Results: During the follow-up period, 258 men were admitted to hospital with COPD, 211 of whom were smokers at baseline. The incidence of hospital admissions for COPD was significantly associated with the number of raised ISPs. Adjusted for risk factors, the hazards ratio (95% CI) was 1.00 (reference), 1.28 (0.9 to 1.9), 1.29 (0.8 to 2.0) and 2.30 (1.6 to 3.2), respectively, for men with 0, 1, 2 and ⩾3 ISPs in the top quartile (p for trend <0.001). This relationship was consistent in men with high and low lung function at baseline. The relationship with the incidence of hospital admissions for COPD was largely the same for all individual ISPs.

Conclusion: Raised plasma ISP levels are associated with an increased incidence of COPD requiring hospitalisation.

https://doi.org/10.1136/thx.2008.102079

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    Footnotes

    • Funding: The study was supported by grants from the Swedish Heart and Lung Foundation, the Swedish Research Council, Malmö University Hospital and grants from LU-ALF.

    • Competing interests: GE is employed as senior epidemiologist by AstraZeneca R&D. C-GL has been paid for lectures by AstraZeneca, Boehringer-Ingelheim, GlaxoSmithKline and Pfizer; taken part and been paid for ad hoc advisory boards for the same companies; and has had institutional support as unrestricted grants from AstraZeneca, Boehringer-Ingelheim and GlaxoSmithKline.

    • Ethics approval: The health service authority of Malmö approved and funded the screening programme. All participants gave informed consent.