The Effects of Ramadan-Fasting (RF) on Inflammatory and Hematological Indices of Stable Chronic Obstructive Pulmonary Disease (COPD) Male Patients: A Pilot Study.

ABSTRACT

No previous study has evaluated the effects of RF on inflammatory and hematological indices of COPD patients. The main objective of the present pilot study was to assess the effects of RF on some inflammatory and hematological indices measured in male patients with stable COPD. Fifteen COPD patients (mean ± SD of age 71 ± 6 years) who fasted during Ramadan 2017 volunteered for the study. Three sessions (Before-Ramadan, End-Ramadan and After-Ramadan) were selected. Spirometry tests and blood samples were consistently performed 2.5-4.5 hr before the interruption of the fasting. Assessment sessions comprised spirometry, inflammatory [erythrocyte sedimentation rate (ESR); C-reactive protein (CRP)] and hematological [red and white blood cells (RBC, WBC); hemoglobin; hematocrit; mean corpuscular volume; mean corpuscular hemoglobin; platelets] indices. Findings were analyzed by applying Friedman ANOVA. The median (lower-upper quartiles) of ESR (Before-Ramadan 3 (2-9), End-Ramadan 7 (0-13), After-Ramadan 9 (5-15) mm/h) and CRP (Before-Ramadan 20 (11-38), End-Ramadan 15 (9-34), After-Ramadan 20 (12-46) mg/L) were not significantly affected by RF. Among all the hematological indices, RF influenced only hemoglobin (Before-Ramadan 14.4 ± 2.2, End-Ramadan 13.4 ± 1.3, After-Ramadan 12.2 ± 0.9 g/dL), hematocrit (Before-Ramadan 45 ± 7, End-Ramadan 40 ± 4, After-Ramadan 39 ± 4%), RBC (Before-Ramadan 5.1 ± 1.0, End-Ramadan 4.6 ± 0.7, After-Ramadan 4.4 ± 0.5 106/mm3) and WBC (Before-Ramadan 8,673 ± 1,911, End-Ramadan 7,840 ± 1,526, After-Ramadan 9,507 ± 2,190/mm3). Compared to the Before-Ramadan session, the End-Ramadan session values for hemoglobin, hematocrit, RBC and WBC were lower. Compared to the After-Ramadan session, the End-Ramadan session values for hemoglobin and WBC were higher and lower, respectively. In conclusion, RF caused significant reduction in hemoglobin, hematocrit, RBC and WBC. However, it did not induce any significant changes in the CRP and ESR indices.