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KMID : 0383820140770060243
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Tuberculosis and Respiratory Diseases
2014 Volume.77 No. 6 p.243 ~ p.250
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Prognostic Value of Serum Growth Differentiation Factor-15 in Patients with Chronic Obstructive Pulmonary Disease Exacerbation
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Kim Mi-Young
Cha Seung-Ick
Choi Keum-Ju
Shin Kyung-Min
Lim Jae-Kwang
Yoo Seung-Soo
Lee Jae-Hee
Lee Shin-Yup
Kim Chang-Ho
Park Jae-Yong
Yang Dong-Heon
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Abstract
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Background: Information regarding prognostic value of growth differentiation factor 15 (GDF-15) and heart-type fatty acid-binding protein (H-FABP) in patients with chronic obstructive pulmonary disease (COPD) exacerbation is limited. The aim of this study was to investigate whether serum levels of GDF-15 and H-FABP predict an adverse outcome for COPD exacerbation.
Materials and Methods: Clinical variables, including serum GDF-15 and H-FABP levels were compared in prospectively enrolled patients with COPD exacerbation that did or did not experience an adverse outcome. An adverse outcome included 30-day mortality and need for endotracheal intubation or inotropic support.
Results: Ninety-seven patients were included and allocated into an adverse outcome (n=10) or a control (n=87) group. Frequencies of mental change and PaCO2>37 mm Hg were significantly higher in the adverse outcome group (mental change: 30% vs. 6%, p=0.034 and PaCO2>37 mm Hg: 80% vs. 22%, p<0.001, respectively). Serum GDF-15 elevation (>1,600 pg/mL) was more common in the adverse outcome group (80% vs. 43%, p=0.041). However, serum H-FABP level and frequency of serum H-FABP elevation (>755 pg/mL) did not differ between the two groups. Multivariate analysis showed that an elevated serum GDF-15 and PaCO2>37 mm Hg were significant predictors of an adverse outcome (odds ratio [OR], 25.8; 95% confidence interval [CI], 2.7?243.8; p=0.005 and OR, 11.8; 95% CI, 1.2?115.3; p=0.034, respectively).
Conclusion: Elevated serum GDF-15 level and PaCO2>37 mm Hg were found to predict an adverse outcome independently in patients with COPD exacerbation, suggesting the possibility that serum GDF-15 could be used as a prognostic biomarker of COPD exacerbation.
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KEYWORD
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Pulmonary Disease, Chronic Obstructive, Disease Progression, Growth Differentiation Factor 15, FABP3 Protein, Human
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