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Correlation of Immunoglobulin Free Light Chains in Risk Stratification for Chronic Obstructive Pulmonary Disease Patients: A Cross-sectional Observational Study
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DOI：10.7860/JCDR/2026/80755.22815.png)
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Abstract
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Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a major cause of morbidity and mortality worldwide. Immunoglobulin free Light Chains (IgLCs) have been implicated in various inflammatory diseases; however, their role in COPD risk stratification remains unclear. Aim: To assess the correlation between IgLC levels and COPD severity and to evaluate their potential role in disease monitoring. Materials and Methods: This cross-sectional observational study was conducted at Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India, between March and December 2018. A total of 120 stable COPD patients aged over 40 years (post-bronchodilator FEV1/FVC <70%) with no exacerbations in the preceding three months were included. COPD severity was staged according to the GOLD (Global Initiative for Chronic Obstructive Pulmonary Disease) criteria using spirometry. Venous blood samples were analysed for serum kappa and lambda free light chains using immunoturbidimetry, along with standard biochemical parameters. Demographic and exposure-related data, including age, sex, Body Mass Index (BMI), smoking status, biomass exposure, and history of tuberculosis, were recorded. Associations between IgLC levels, COPD severity, lung function (FEV1%), and biochemical parameters were analysed using Pearson's correlation, Analysis of Variance (ANOVA), and Chi-square tests. A p-value <0.05 was considered statistically significant. Results: The study included 120 COPD patients, comprising 45 (37.5%) males and 75 (62.5%) females, with a mean age of 59.2 +/- 10.6 years. The distribution across COPD stages was as follows: 20 (16.7%) in Stage I, 32 (26.7%) in Stage II, 40 (33.3%) in Stage III, and 28 (23.3%) in Stage IV. No significant differences were observed across disease stages with respect to sex, smoking status, biomass exposure, or history of tuberculosis (p-value >0.05). Pulmonary function (FEV1%) declined significantly with increasing COPD severity, from 82.10 +/- 1.21% in Stage I to 26.21 +/- 2.45% in Stage IV (F=308.166, p-value <0.0001). Serum kappa and lambda free light chain levels increased progressively with disease severity (kappa: 2.94 +/- 0.57 g/L to 5.50 +/- 0.81 g/L, F=87.318, p-value <0.0001; lambda: 1.50 +/- 0.26 g/L to 2.80 +/- 0.53 g/L, F=43.616, p-value <0.0001), whereas the kappa:lambda ratio remained stable across all stages (p-value=1.000). Conclusion: Elevated IgLC levels showed a strong correlation with worsening COPD severity, declining lung function, and reduced BMI. Despite increases in individual kappa and lambda light chain concentrations, the kappa:lambda ratio remained stable across disease stages.
Keywords:
Body mass index
Pulmonary function tests
Risk assessment
Smoking
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