engleski

Potential role of leukocyte indices as diagnostic parameters for chronic obstructive pulmonary disease

Introduction: Chronic obstructive pulmonary disease (COPD) is an inflammatory disease characterized by airflow limitation. Many of inflammatory cells are involved in the pathogenesis of COPD, mostly leukocytes with its subtypes. The counts of inflammatory cells are often used in describing the severity of inflammation. Besides them, the combinations of those parameters could potentially become inflammatory markers in COPD. Moreover, they could be used in predicting the disease and in describing its severity. The aim of the study was to assess neutrophil to lymphocyte ratio (NLR), basophil to lymphocyte ratio (BLR) and monocyte to lymphocyte ratio (MLR) in COPD patients in comparison with healthy controls, to investigate prediction value of mentioned ratios, and their correlation with the disease severity. Material & methods: The present study included 109 patients with stable COPD and 95 healthy individuals. We determined counts of leukocytes and its subtypes – neutrophils, basophils, monocytes and lymphocytes. The results were used for the calculation of the ratios – NLR, BLR and MLR. Patients were subdivided according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification from 2019 in A-D groups, and according to the forced expiratory volume in 1 second (FEV1) in GOLD 2-4 stages. We investigated association of the ratios with the severity of airflow limitation (GOLD 2-4 stages), GOLD A-D groups, and correlation with spirometry results. We also evaluated diagnostic prediction of the ratios using univariate logistic regression analysis. Results: NLR (P<0.001), BLR (P<0.001) and MLR (P<0.001) were increased in COPD patients when compared to healthy volunteers. All three of them successfully distinguished healthy individuals from every GOLD 2-4 stage (P<0.001), while only BLR managed in discriminating healthy controls from every GOLD A-D group (P<0.001). NLR inversely correlated with FEV1/forced vital capacity (FVC) (r = -0.335, P<0.001) which means it is associated with the presence of airway obstruction. In addition, NLR showed predicting significance with its odds ratio of 2.863 (P<0.001). Conclusion: NLR, BLR and MLR are simple and widely available leukocyte indices that showed good diagnostic performances in evaluation of COPD. NLR correlated with the airflow limitation and it could be considered as a good predictor of COPD.

COPD, leukocytes, NLR, BLR, MLR

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