During the 12-month follow-up period, 88 of the 179 study participants developed moderate COPD exacerbations, including 72 with low serum levels of GPX4, 57 with high serum levels of sTfR1, 55 with high serum levels of AIFM2, 51 with high serum levels of ACSL4, and 68 with high sTfR1/GPX4. Here, ACSL4 is linked to chronic obstructive pulmonary disease.