The aim of our study was to estimate the role of smoking and obesity(O) as a risk factors which cause the changes of the concentration plasma levels of surfactant protein-D (SP-D) in patients (pts) with acute exacerbation (AE) COPD.

We observed 78 pts with AE COPD, 12 stable COPD pts without O, non-smokers (comparison group (CG)) and 10 healthy non-smokers persons (H). They made the study samples. All AE COPD pts were divided into groups: group 1 - 24 smokers pts with O and AE COPD, group 2 ? 20 smokers pts with AE COPD without O, group 3 ? 22 non-smokers pts with O and AE COPD, group 4 ? 12 non-smokers pts with AE COPD without O. Plasma levels of SP-D were measured by ELISA on the first day of admission to the hospital in addition to general clinical examination, estimation of BMI, CRP and spirometry.

SP-D levels in pts with AE COPD were significantly higher in all groups than in CG and H (p?0,05). SP-D levels in group 1 were statistically higher than in all groups of AE COPD pts (p?0,05). There was a tendency to higher levels of SP-D in group 2 in compere with group 3, but there wasn`t statistically  difference (p?0,072). The SP-D levels in group 4 were significantly lower than in group 1, 2 and 3, but had statistically difference with CG (p?0,05). There were a negative correlation between SP-D and BMI, FEV1%, FVC% and FEV1/FVC. There was a positive correlation between SP-D and CRP in group 1 and 2.

Our data indicate that smoking and obesity as combined risk factors aggressively increase the plasma levels of SP-D in pts with AE COPD. Smoking and obesity as a separate risk factor negatively affecting at the systemic inflammation and poses a problem of higher risk for infections.