Association between multimarkers of metabolic malnutrition and inflammation and risk of chronic obstructive pulmonary disease and lung function: a prospective cohort study of UK biobank

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BACKGROUND: Chronic obstructive pulmonary disease (COPD) pathogenesis involves the cross-links between inflammation, oxidative stress, and metabolic dysregulation leading to irreversible airflow limitation. The metabolic vulnerability index (MVX) integrates inflammation and metabolic malnutrition related metabolic biomarkers that may reflect these underlying mechanisms. This study aimed to assess the associations of MVX score with risk of incident COPD and lung function in the UK Biobank. METHODS: The sex-specific MVI score was developed as a composite biomarker, which integrates six nuclear magnetic resonance (NMR)-based plasma biomarkers, including glycoprotein acetyls (GlycA), small high-density lipoprotein particles (sHDL), citrate, and the branched-chain amino acids (isoleucine, leucine, and valine). Multivariable Cox or linear regression model was used to assess the association of MVX score with risk of COPD and lung function level, respectively. RESULTS: A total of 240,873 participants were included. The results showed that per 1-SD increase in MVX score was associated with a 19% increased risk of COPD (HR: 1.19, 95% CI: 1.16, 1.21). Furthermore, compared to low MVX score group (Q1), high MVX score group (Q4) was associated with 55% increased risk of COPD (HR: 1.55, 95% CI: 1.45, 1.66). Furthermore, per 1-SD increase in MVX score was associated with decreased lung function level, including FVC (β: -67.55, 95% CI: -71.36, -63.74) and FEV1 (β: -52.24, 95% CI: -55.34, -49.14). Compared to low MVX score group (Q1), high MVX score group (Q4) was also associated with lower FVC (β: -174.78, 95% CI: -185.47, -164.10) and FEV1 (β: -135.72, 95% CI: -144.42, -127.02) levels. Furthermore, we observed the significant dose-response relationship between MVX score and COPD risk and lung function level. CONCLUSION: Our study demonstrates that higher MVX score, reflecting inflammation and metabolic malnutrition, is significantly associated with increased COPD risk and impaired lung function. These findings suggest that MVX score may help identify high-risk individuals for early intervention.

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