Analysis of Blood Biomarkers in Patients with Chronic Obstructive Pulmonary Disease (COPD) and with Asthma-COPD Overlap (ACO)

Figures & data

Figure 1. (A) Scatterplot of individual data of the neutrophil/lymphocyte ratio (NLR) according to the diagnosis of ACO. Dotted lines correspond to the normal reference values. (B) Scatterplot of individual data the platelet/lymphocyte ratio (PLR) according to the diagnosis of ACO. Dotted lines correspond to the normal reference values.

Table 1. Demographic and clinical characteristics of ACO patients and the remaining COPD patients.

Variable	Total (n = 77)	Non-ACO group (n = 53)	ACO group (n = 24)	p value
Age (years)	66.4 (8.7)	66.0 (8.9)	67.2 (8.4)	0.589
Sex (male), n (%)	56 (72.7)	37 (69.8)	19 (79.2)	0.393
Smoking history
-Smokers, n (%)	19 (24.6)	12 (22.6)	7 (22.2)	0.538
-Pack-years (smokers and exsmokers)	52.3 (32.1)	54.1 (33.6)	48.6 (28.9)	0.569
Respiratory symptoms
Dyspnoea (mMRC)	1.9 (0.9)	1.8 (0.9)	2.1 (0.8)	0.138
Dyspnoea mMRC ≥ 2, n (%)	45 (58.4)	27 (50.9)	18 (75)	0.047
Chronic cough, n (%)	45 (58.4)	33 (62.3)	12 (50)	0.312
Wheezing, n (%)	25 (32.5)	12 (22.6)	13 (54.2)	0.004
Expectoration, n (%)	44 (57.1)	30 (56.6)	14 (58.3)	0.887
FEV1 %	45.3 (16.1)	45.1 (15.7)	45.8 (17.3)	0.996
Previous diagnosis of asthma, n (%)	8 (10.4)	3 (5.7)	5 (20.8)	0.043
Comorbidities
Hypertension	38 (49.3)	26 (49.1)	12 (50)	0.931
Dyslipemia	30 (38.9)	22 (41.5)	8 (33.3)	0.496
Cardiovascular disease	29 (37.6)	21 (39.3)	8 (33.3)	0.695
Neoplasm	22 (28.5)	17 (32.1)	5 (20.7)	0.312
Depression	22 (28.5)	14 (26.4)	8 (33.3)	0.534
Osteoporosis	15 (19.4)	12 (22.6)	3 (12.5)	0.298
Diabetes	12 (15.6)	9 (17)	3 (12.5)	0.616
Arthritis	5 (6.5)	4 (7.5)	1 (4.8)	0.577
Charlson index	4.17 (1.7)	4.19 (1.9)	4.13 (1.7)	0.890
Moderate exacerbations	1.1 (1.3)	1 (1.2)	1.3 (1.2)	0.329
Hospitalisations	0.7 (1.0)	0.6 (0.9)	0.8 (1.3)	0.784
Inhaled treatment, n (%)
-LABA	69 (89.6)	46 (86.8)	23 (95.8)	0.228
-LAMA	74 (96.1)	52 (98)	22 (91.7)	0.176
-ICS	48 (62.3)	29 (54.7)	19 (79.2)	0.040

Footnote:Values are means (standard deviations), unless otherwise specified. mMRC: modified Medical Research Council; FEV1: forced expiratory volume in the first second; LABA: long-acting β2-agonists; LAMA: long-acting muscarinic antagonists; ICS: inhaled corticosteroids.

Table 2. Laboratory findings of ACO patients and the remaining COPD patients.

Laboratory parameter	Total (n = 77)	Non-ACO group (n = 53)		ACO group (n = 24)
		Values	Out of range Below/normal/above	Values	Outside the range Below/normal/above
White blood cell count (x10E9/L)	8.5 (2.4)	8.4 (2.4)	0/45 (85%)/8 (15%)	8.9 (2.4)	0/20 (83%)/4 (17%)
Neutrophils (%)	62.2 (10.8)	64.7 (10.9)	1 (1.9)/47 (89%)/5 (9%)	56.8 (8.6)*	1 (4)/23 (96%)/0
Neutrophils (x10E9/L)	5.6 (2.2)	5.5 (2.3)	0/43 (81%)/10 (19%)	5.7 (2.2)	0/20 (83%)/4 (17%)
Lymphocytes (%)	25.8 (9.5)	24.2 (9.7)	17 (32%)/35 (66%)/1 (2%)	29.3 (8.2)*	3 (13)/21 (88%)/0
Lymphocytes (x10E9/L)	2.1 (0.9)	2.0 (0.9)	9 (17%)/42 (79%)/2 (4%)	2.6 (0.9)*	1 (4%)^&/19 (79%)/4 (17%)
Monocytes (%)	8.5 (7.4)	8.6 (2.1)	1 (2%)/43 (81%)/9 (17%)	8.2 (2.1)	1 (4%)/22 (92%)/1 (4%)
Monocytes (x10E9/L)	0.8 (0.8)	0.7 (1.0)	0/44 (83%)/9 (17%)	1.0 (1.3)	0/18 (75%)/6 (25%)
Eosinophils (%)	2.8 (2.0)	1.9 (1.2)	0/51 (96%)/2 (4%)	4.7 (2.1)*	0*/15 (63%)/9 (38%)
Eosinophils (x10E9/L)	0.2 (0.2)	0.1 (0.08)	0/53 (100%)/0	0.4 (0.2)**	0*/18 (75%)/6 (25%)
Basophils (%)	0.6 (0.3)	0.6 (0.3)	0/53 (100%)/0	0.8 (0.4)*	0/24 (100%)/0
Basophils (x10E9/L)	0.05 (0.07)	0.03 (0.1)	0/51 (96%)/2 (4%)	0.08 (0.07)**	0/22 (92%)/2 (8%)
Platelets (x10E9/L)	264 (70.9)	261 (71.5)	3 (6%)/48 (91%)/2 (4%)	270 (70.7)	0/23 (96%)/1 (4%)
CRP (mg/dL)	1.1 (1.3)	1.2 (1.4))	0/20 (44%)/25 (56%)	0.8 (0.9)	0/10 (56%)/8 (44%)
Fibrinogen (g/dL)	4.0 (0.8)	3.9 (0.8)	0/49 (100%)/0	4.0 (0.8)	0/23 (96%)/1 (4%)
NLR	3.2 (2.8)	3.8 (3.9)	1 (2%)/35 (66%)/17 (32%)	2.5 (1.6)*	0/21 (88%)/3 (12%)
PLR	146 (81)	160 (90)	1 (2%)/45 (85%)/7 (13%)	115 (44)^&	3 (12%)*/21 (88%)/0
Haemoglobin (g/dL)	14.9 (2.1)	14.7 (2.3)	6 (11%)/41 (77%)/6 (11%)	15.9 (1.8)	4 (17%)/16 (67%)/4 (17%)

Values are means (standard deviations) unless specified; CRP: C-reactive protein; NLR: neutrophil/lymphocyte ratio; PLR: platelet/lymphocyte ratio.

Values highlighted in bold are significant or of borderline significance comparing ACO with Non-ACO groups. *p < 0.05; **p < 0.01; ^&p < 0.10.