A Cross-sectional Comparative Study of hs-CRP Levels between Non Diabetic and Diabetic Patients of Chronic Obstructive Pulmonary Disease

Abstract

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is characterised by persistent airflow limitation and is a global health issue with high social and economic burden. Type 2 Diabetes Mellitus (T2DM) is a major global metabolic disorder affecting approximately 300 million individuals worldwide. Accordingly, chronic low grade systemic inflammation is probably one of the common denominators between COPD and T2DM. Aim: To evaluate the status of systemic inflammation in COPD patient with/without T2DM, using quantitative serum high sensitivity C-Reactive Protein (hs-CRP) and Total Leucocyte Count (TLC). Materials and Methods: This cross-sectional study was conducted for a period of one year from May 2019 to April 2020 on 100 patients of COPD patients attending outpatient department. Either known patients of COPD or patients with complains of chronic cough was evaluated with chest x-ray and pulmonary function test (spirometry) after thorough history and physical examination. Global Initiative for Chronic Obstructive Lung Disease-GOLD guidelines a grading system for COPD was used for assessing severity. For assessing diabetes, criteria adopted from American Diabetes Association (ADA) i.e., symptoms of diabetes plus random plasma glucose >200 mg/dL (11.1 mMol/L). Venous blood samples were obtained to perform quantitative hs-CRP estimation by immune turbidimetry method as a marker of systemic inflammation. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) version 26.0 of International Business Machines (IBM) Corporation, California, United States of America (USA). Results: The T2DM was present in 40% COPD patients. The frequencies of T2DM in patients with GOLD stages I, II, III, and IV were 16%, 45%, 28%, and 11%, respectively. The mean hs-CRP levels for diabetic group was 5.45±1.07 mg/L, which was significantly higher (p<0.05) than 2.26±0.69 mg/L that of non diabetic group. Conclusion: Present study concluded that the inflammatory process is a definite pathophysiological factor that has a significant link between COPD and T2DM and can be evaluated using a marker like hs-CRP level and TLC.