Evaluating the Role of Serum C-Reactive Protein as a Biomarker among Patients with Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study

Chronic obstructive pulmonary disease (COPD) is a multi-component systemic disease with elevated serum C-reactive protein (CRP) levels in stable conditions and during exacerbations. Serum CRP is an important biomarker and increased CRP levels lead to diminished lung function, decreased stamina to exercise, and poor quality of life in COPD patients.

This study aimed to determine the relationship between serum CRP levels and the impact of various risk factors and associated morbidities among patients with COPD attending a tertiary care hospital in Bhubaneswar.

205 stable COPD patients were enrolled. The CRP levels were analyzed with reference to the patients’ sociodemographics, clinical profiles, symptoms, and risk factors.

In our study, more males were enrolled. It was observed that most of them were in the age group of 51-60 years, residing in urban areas, and belonging to a lower socio-economic group living in houses with no proper ventilation. A significant proportion of COPD patients had exposure to smoke, biomass, or dust for 20 years or more. There was no significant difference in age distribution and socio-economic status across genders. Urban slums (p = 0.048), illiteracy (p < 0.0001), ventilation status (p = 0.0009), and exposure to tobacco, smokeless tobacco, dust, etc. (p < 0.00001), were significant factors. 73% of male and 59% of female COPD patients were taking both oral and inhaler medicines. The majority of COPD patients had normal BMI. Females had a higher prevalence of wheezing symptoms (p < 0.00001), obesity (BMI ≥ 30.0), pre-diabetes (p = 0.044), and diabetes (p = 0.0200). 13% of male COPD patients had hypertension. 55% of the COPD patients had 3-10 mg/L of serum CRP, and 81% were in stage 1, 12% in stage 2, and 6% in stage 3 (GOLD). No significant gender difference in GOLD stage, duration of COPD, medication type, and hospitalization rates was observed. A higher proportion of males exhibited night/morning cough and an FEV1/FVC ratio of less than 70% predicted value. The differences in CRP levels across stages were statistically significant. The findings have provided valuable insights into the inflammatory status of COPD patients based on CRP levels, varying symptomatology, and lung function impairment.

COPD patients, in general, have increased levels of CRP; this emphasizes the measurement of CRP in stable COPD patients.