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. 2022 Aug 16;14(1):115.
doi: 10.1186/s13098-022-00887-w.

MAFLD associated with COPD via systemic inflammation independent of aging and smoking in men

Tsubasa Tsutsumi  1 , Dan Nakano  2 , Machiko Kawaguchi  2 , Ryuki Hashida  3 , Shinobu Yoshinaga  4 , Hirokazu Takahashi  5 , Keizo Anzai  5 , Takumi Kawaguchi  2
Affiliations

MAFLD associated with COPD via systemic inflammation independent of aging and smoking in men

Tsubasa Tsutsumi et al. Diabetol Metab Syndr. .

Abstract

Background and aim: Metabolic dysfunction and associated systemic inflammation are risk factors for chronic obstructive pulmonary disease (COPD) and COPD is highly prevalent in men. We investigated the impact of metabolic-associated fatty liver disease (MAFLD) and MAFLD-related systemic inflammation on COPD in men.

Methods: We enrolled 2,041 men with fatty liver. Patients were classified into the COPD (n = 420/2041) and non-COPD (n = 1621/2041) groups. COPD and its high-risk group were diagnosed using the Japanese Respiratory Society Disease statement. Systemic inflammation was evaluated using the C-reactive protein (CRP)/albumin ratio. Independent factors for COPD were investigated by multivariate analysis and decision-tree analysis.

Results: The prevalence of MAFLD was significantly higher in the COPD group than in the non-COPD group. In multivariable analysis, in addition to heavy smoking and aging, MAFLD was identified as an independent factor for COPD (OR 1.46, 95% CI 1.020-2.101, P = 0.0385). Decision-tree analysis showed that MAFLD, rather than heavy smoking, was the most influential classifier for COPD in non-elderly men (14% in MAFLD vs 6% in non-MAFLD groups). MAFLD was also the second most influential factor in elderly men who were not heavy smokers. In both groups, the CRP/albumin ratio was the first classifier for COPD (16% in the high CRP/albumin ratio group vs 3% in the low CRP/albumin ratio group of non-elderly men).

Conclusions: MAFLD is an independent predictor of COPD in men. MAFLD had a significant impact on COPD through systemic inflammation in men of all ages who were not heavy smokers. MAFLD may be useful to broadly identify COPD in men.

Keywords: CRP/albumin ratio; Chronic obstructive pulmonary disease; Metabolic associated fatty liver disease; Steatosis; Systemic inflammation.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of patient selection
Fig. 2
Fig. 2
Independent factors for the presence of chronic obstructive pulmonary disease in all subjects. MAFLD metabolic-associated fatty liver disease
Fig. 3
Fig. 3
A Profiles associated with chronic obstructive pulmonary disease were evaluated by decision tree analysis (B) Prevalence of metabolic-associated fatty liver disease-related profiles in patients with chronic obstructive pulmonary disease. COPD chronic obstructive pulmonary disease, MAFLD metabolic-associated fatty liver disease
Fig. 4
Fig. 4
A Decision tree analysis for factors associated with COPD in patients with metabolic-associated fatty liver disease-related Profile 1. B Decision tree analysis for factors associated with chronic obstructive pulmonary disease in patients with metabolic-associated fatty liver disease-related Profile 2. COPD chronic obstructive pulmonary disease, CRP C-reactive protein, BMI body mass index
See this image and copyright information in PMC

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