Association between dynamic changes in the modified Glasgow prognostic score and disease progression in idiopathic pulmonary fibrosis

Abstract

Abstract Background Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive interstitial lung disease with a highly variable clinical course. Identifying reliable and easily accessible biomarkers associated with disease progression remains a major clinical challenge. The modified Glasgow Prognostic Score (mGPS), reflecting systemic inflammation and nutritional status, has been widely used in other chronic diseases, but its role in IPF has not been fully established. To evaluate the association between baseline and follow up mGPS values and disease progression in patients with idiopathic pulmonary fibrosis. Methods This retrospective cohort study included 143 patients diagnosed with IPF who were followed at a tertiary referral center between 2017 and 2026. Disease progression was defined according to ATS/ERS guideline criteria. Baseline and follow up mGPS values were calculated using serum C-reactive protein and albumin levels. Clinical, functional, and laboratory parameters were analyzed. Univariate and multivariate logistic regression analyses were performed to identify factors independently associated with disease progression. Results Disease progression was observed in 63 patients (44.1%). Baseline mGPS distribution did not differ significantly between the progression and non progression groups ( p = 0.056), and baseline mGPS was not independently associated with disease progression in multivariate analysis. In contrast, follow up mGPS values were significantly higher in patients with disease progression ( p < 0.001). Female sex (OR: 4.837, p = 0.003), lower body mass index (OR: 0.736, p = 0.004), diabetes mellitus (OR: 5.107, p = 0.001), lower baseline FVC (OR: 0.969, p = 0.022), and higher LDH levels (OR: 1.005, p = 0.002) were independently associated with disease progression. Conclusion Baseline mGPS was not independently associated with disease progression in IPF, whereas follow up mGPS values were significantly associated with disease progression. These findings suggest that longitudinal assessment of mGPS may serve as a dynamic monitoring tool rather than a static baseline prognostic marker. Serial evaluation of simple biomarkers such as CRP and albumin may improve longitudinal risk assessment in patients with IPF.