Clinical significance of mean platelet volume/lymphocyte ratio and mean platelet volume/platelet ratio in the exacerbation of chronic obstructive pulmonary disease

Objectives: Studies showing the role of systemic inflammation in chronic obstructive pulmonary disease(COPD) are increasing. Particularly, importance of mean platelet volume (MPV) and neutrophil/lymphocyteratio (NLR) for acute exacerbation of COPD has been reported. The use of MPV/lymphocyte ratio (MLR) andMPV/platelet ratio(MPR) in acute exacerbation of COPD patients was investigated in our study, consideringthat MPV alone may be a more valuable marker of inflammation.Methods: Between March 2017 and March 2018, COPD patients who applied to Abant Izzet Baysal UniversitySchool of Medicine, Chest Diseases outpatient clinic were examined. Results were retrospectively scannedfrom patient files after institutional approval. Sixty-four (60.4%) stable COPD and 42 (39.6%) acuteexacerbation COPD patients were included in the study.Results: Seventy-one (67%) of patients were male and 35 (33%) were female. NLR was 2.26 (0.93-6.48) instable patients and 4 (1.18-36) in acute attack patients (p < 0.001); PLR was 137.44 (66.9-436.6) in patientswith stable disease and 162.8 (85-1056.6) in patients with attack (p = 0.068). MLR was 5 (2.92-25) in acuteattack patients and 4 (1.89-8.67) in stable patients; this difference was statistically significant (p = 0.003). MPVwas found to be 7 (5.5-9.1) fL in patients with stable disease and 8 (5-13.4) fL in acute patients. This differencewas statistically significant (p < 0.001). MPR was found to be statistically significantly higher in acute patientsthan in patients with stable disease (p = 0.04). WBC, neutrophil and CRP were found to be statisticallysignificantly higher in acute patients than in stable patients (p < 0.05). There was a statistically significantcorrelation between WBC and NLR (r = 0.269, p = 0.005) and between CRP and NLR (r = 0.379, p < 0.001).Conclusions: Hemogram parameters from routine laboratory tests in COPD patients are cheap and easilyaccessible. It is important to detect the presence of subclinical inflammation in the stable phase, as well as toidentify patients at risk of exacerbation. Prospective studies are needed to demonstrate correlations withinflammatory markers.