الفهرس 
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Abstract
Chronic obstructive pulmonary disease (COPD) is one of the most
important respiratory causes of chronic morbidity and mortality throughout
the world. Currently, COPD ranks fourth as a cause of death in the United
States, behind heart disease, cancer, and stroke and further increases in its
prevalence and mortality are expected in the near future.
Although COPD affects the lungs, it also produces significant systemic
consequences.
These consequences can be detected clinically and appear to be
associated with the presence of different groups of systemic inflammatory
markers.
This work aimed to evaluate serum TNF-α levels in patients with
COPD and its relation with BMI.
This observational case control study was carried out in El-Mahala
chest hospital and in Chest and Medical Biochemistry Departments, Faculty
of Medicine, Menoufia University, and over 24 month’s period from july
2016 until july 2018.
It was conducted on 50 subjects divided into 2 groups after having an
informed consent.
group A: included 40 COPD patients (30 males and 10 females),
divided into 3 subgroups: group A1 included 13 COPD patients with low
BMI, group A2 included 12 COPD patients with normal BMI and, group A3
included 15 COPD patient with high BMI.
group B: included 10 subjects apparently healthy volunteers, age and
sex-matched, after having an informed consent (5males and 5females).
An informed consent was taken from all participants.
All subjects underwent:
Full history taking including previous exacerbations and estimation of
modified medical research counseling (mMRC) scale:
1- Full Clinical examination including general and local chest examinations.
2- Chest x-ray (PA and lateral views) and chest CT when needed.
3- Complete blood count and ESR.
4- Fasting and post prandial blood sugar.
4- Liver function tests.
5- Kidney function tests.
6- Pulmonary function tests. (FVC maneuver with reversibility testing).
7-BMI measurement:
Individual’s body weight divided by the square of his height. kg/ m2.
8- Serum TNF-α measurement by ELISA method.
Results of this study revealed that:
There was a highly significant difference between control and patients
groups regarding FEV1% of predicted (p value < 0.001).
Statically significant difference was reported between both
groups(groupA and groupB) (p<0.05) as regard BMI.
There was no significant difference between the control and patients
groups (p>0.05) regarding to TNF- α.
There was a highly significant inverse correlation between serum
TNF -α level in COPD patients and their BMI (p value <0.001).
There was a negative but insignificant correlation between serum TNF- α
level in COPD patients and smoking index.
There was a negative but insignificant correlation between serum TNF- α
level in COPD patients and FEV1