title: A gender difference in circulating neutrophils in malnourished patients with COPD.
abstract: BACKGROUND
  Circulating markers of inflammation in chronic obstructive pulmonary disease (COPD) may correlate to disease progression and extrapulmonary complications such as malnourishment. However, surprisingly little is known about gender-related differences for circulating inflammatory markers in COPD.
  
  
  OBJECTIVE
  To characterize differences in circulating markers of inflammation in malnourished female and male patients with COPD.
  
  
  METHODS
  Thirty female and 11 male patients with a clinical diagnosis of COPD and malnourishment were examined. A group of control subjects without evidence of COPD was recruited for comparison of some variables.
  
  
  METHODS
  Blood samples were drawn, and the following parameters were studied: leukocytes and differential counts, C-reactive protein (CRP), tumor necrosis factor-α, interleukin (IL)-6 and IL-8, myeloperoxidase (MPO), neutrophil elastase (NE), intracellular adhesion molecule-1, vascular endothelial adhesion molecule-1, and E-selectin.
  
  
  RESULTS
  The mean neutrophil concentration was significantly (P = 0.019) higher in female (4.5 × 10(9)/L) than in male patients with COPD (3.5 × 10(9)/L) and significantly higher than in female control subjects (3.1 × 10(9)/L) (P < 0.01, n = 85). The mean CRP values were considerably higher in female (4.9 mg/mL) than in male patients with COPD (1.5 mg/mL), but the difference was not statistically significant (P = 0.20). The mean concentrations of IL-6 and IL-8 tended to be higher in female than in male patients with COPD, but these differences did not reach statistical significance either (P > 0.05). Confounding factors (smoking, medication) could not explain the gender differences noted. The concentrations of MPO and NE displayed a strong correlation (r = 0.89; P < 0.01, n = 41) but revealed no gender differences. The latter was true for concentrations of adhesion molecules as well.
  
  
  CONCLUSIONS
  Our study puts forward evidence of a gender-related difference in systemic inflammation in malnourished patients with COPD in terms of circulating neutrophils being more abundant in female patients. Among these female patients, there was also a trend toward an increase in two neutrophil-mobilizing cytokines. New and better-powered studies are warranted to confirm and characterize this potentially important phenomenon in greater detail.
authors.affiliation: Department of Internal Medicine/Respiratory Medicine and Allergology, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
authors.forename: Sven
authors.initials: S
authors.lastname: Larsson
authors.forename: Anita
authors.initials: A
authors.lastname: Nordenson
authors.forename: Pernilla
authors.initials: P
authors.lastname: Glader
authors.forename: Shigemi
authors.initials: S
authors.lastname: Yoshihara
authors.forename: Anders
authors.initials: A
authors.lastname: Lindén
authors.forename: Frode
authors.initials: F
authors.lastname: Slinde
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001993:Bronchodilator Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D007958:Leukocyte Count; D016014:Linear Models; D008168:Lung / Q000503:physiopathology; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000276:immunology* / Q000503:physiopathology; D009504:Neutrophils / Q000276:immunology*; D009752:Nutritional Status; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000188:drug therapy / Q000276:immunology* / Q000503:physiopathology; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D013548:Sweden
chemical_list: D000305:Adrenal Cortex Hormones; D015415:Biomarkers; D001993:Bronchodilator Agents; D018836:Inflammation Mediators