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Title: [Correlation between systemic inflammation level and emphysema degree and bone mineral density in chronic obstructive pulmonary disease patients and its mechanism].
Author: Hu L, Zhang DW, Jiang HY, Ji S, Wei YY, Hu HQ, Fei GH.
Journal: Zhonghua Jie He He Hu Xi Za Zhi; 2021 Mar 12; 44(3):213-217. PubMed ID: 33721934.
Abstract:
Objective: To study the correlation between systemic inflammation level and emphysema degree and bone mineral density in chronic obstructive pulmonary disease (COPD) patients and its possible mechanism. Methods: 90 patients with stable COPD who met the inclusion criteria and 50 controls in the physical examination center during the same period were recruited. All the enrolled objects have collected general clinical data, analyzed peripheral blood samples, measuring the Low-attenuation area of lung and CT value of lumbar 1 vertebra (L1-CT) by chest spiral CT. According to LAA%, COPD patients were divided into 36 cases of the non-emphysema group, 32cases of mild to moderate emphysema group, and 22 cases of severe emphysema group. The correlation between L1-CT value, LAA%, peripheral blood inflammatory factors, and pulmonary function indices in each group was analyzed and compared. Results: The HU value of L1-CT (107±32) in the COPD group was significantly lower than that in the control group (153±30), and the difference was statistically significant (P<0.05). The higher the LAA% in COPD patients was, the lower the value of L1-CT was, and the difference between groups was statistically significant. Compared with COPD patients in the non-emphysema group, peripheral blood neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and C-reactive protein (CRP) were all increased in the emphysema group, and the differences were statistically significant (P<0.05). L1-CT was negatively correlated with LAA, PLR, NLR, and CRP while uncorrelated with serum concentration of calcium and phosphorus. Conclusion: The decrease in bone density in COPD patients is closely related to the degree of emphysema. It is associated with increased levels of systemic inflammation caused by COPD itself. Early and timely broad-spectrum anti-inflammatory treatment may have certain clinical significance for the prevention and treatment of comorbidity with osteoporosis. 目的： 研究慢性阻塞性肺疾病（慢阻肺）患者系统性炎症水平与肺气肿程度、骨密度改变的相关性及机制探讨。 方法： 招募2019年4月至2020年12月符合入组条件的稳定期慢阻肺患者90例（慢阻肺组），其中男63例，女27例，年龄（71±9）岁；招募同期体检中心的50名体检者（健康对照组），其中男32名，女18名，年龄（68±7）岁。所有入组对象均采集一般临床资料、外周血标本，根据胸部螺旋CT检查完成肺部低衰减区域的百分比（LAA%）及腰1椎体CT值（L1-CT）的测定，根据LAA%测量值将慢阻肺患者分为非肺气肿组（36例）、轻中度肺气肿组（32例）和重度肺气肿组（22例）。分析比较各组间L1-CT值和LAA%、外周血炎症指标、肺功能指标等。 结果： 慢阻肺组L1-CT（107±32）HU值与对照组（153±30）HU相比较低，差异有统计学意义（P<0.05）；慢阻肺患者LAA%越高，L1-CT值越低，组间L1-CT值的差异有统计学意义（P<0.05）；与非肺气肿组的患者相比，肺气肿组（轻中度+重度）患者外周血中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）及C反应蛋白（CRP）均增高，差异均有统计学意义（均P<0.05）。L1-CT值与LAA%、PLR、NLR及CRP均呈负相关，与血清钙、磷浓度无明显相关。 结论： 慢阻肺患者骨密度与肺气肿程度呈负相关，与慢阻肺疾病本身导致的系统性炎症水平升高有关。.

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