Increased levels of systemic inflammation had been
earlier reported in relation to excessive fat mass in COPD
patients. Specifically, tumor necrosis factor-a, interleukin
(IL)-6 and leptin levels in plasma have been shown to be significantly
increased in overweight/obese COPD patients compared
with normal-weight patients [35] and the likelihood of
having elevated C-reactive protein in COPD patients was
found to be 3.3 times higher in obese patients compared to
normal-weight patients, after adjusting for relevant confounders
[36].