Association among weight, comorbidities, inflammation and chronic obstructive pulmonary disease

<bold>Introduction:</bold> Chronic obstructive pulmonary disease (COPD) is the 3rd cause of death worldwide: thus, it is worthwhile to elucidate factors related to its development and progression. <bold>Objectives:</bold> to assess the association among weight, comorbidities, systemic inflammation and COPD. <bold>Methods:</bold> 2841 subjects living in Pisa (54.7% female, 8-97 yr) were investigated in 1991-93, using a questionnaire on health status and risk factors, spirometry and blood tests. The considered outcomes were: COPD presence/absence (diagnosis and/or forced expiratory volume in the 1st second-FEV1/forced vital capacity-FVC<0.70) and COPD severity (moderate/severe: FEV1<80% predicted; mild: ≥80% predicted). Using logistic regression models, the associations among outcomes and weight (underweight/normal: body mass index-BMI<25 kg/m2; overweight/obese: BMI≥25 kg/m2), comorbidities and systemic inflammation (neutrophil/lymphocyte ratio-NLR) were estimated, adjusting for sex, age, education, smoking. <bold>Results:</bold> Mean NLR was significantly higher in subjects with than in those without COPD (2.47 vs 2.12), in underweight/normal COPD subjects than in those overweight/obese (2.94 vs 2.18) and in subjects with than in those without comorbidity (2.51 vs 1.99). Comorbidities were significantly more frequent in overweight/obese than in underweight/normal COPD subjects (95.7% vs 92.9%). COPD was associated with comorbidities (OR 1.764, 95% CI 1.009-3.084) and NLR (OR 1.081, 95% CI 1.004-1.163). Mild COPD was associated with NLR (OR 1.139, 95% CI 1.032-1.258). <bold>Conclusions:</bold> COPD, regardless of BMI, is associated with comorbidities and systemic inflammation, indicating the need to increase prevention and early diagnosis efforts.