Low Serum retinol-binding protein-4 levels in acute exacerbations of chronic obstructive pulmonary disease at intensive care unit admission is a predictor of mortality in elderly patients

Journal of Inflammation

Research

Yufeng Lou¹  Xiaojun He²  Qihui Jin³  Yueliang Chen⁴ 

[1] Department of Clinical Laboratory, The First affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China;Department of Emergency Medicine, Editorial Board of the Chinese Journal of Emergency Medicine, The Second affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China;Department of Geriatric Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China;Department of ICU, Sir Run Run Shaw Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China;

关键词: Acute exacerbations of chronic obstructive pulmonary disease;    Retinol-binding protein-4;    Predictor;    Elderly;    Intensive care unit;   

DOI  :  10.1186/1476-9255-10-31

 received in 2012-12-03, accepted in 2013-09-26,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundAcute exacerbations of chronic obstructive pulmonary disease (AECOPD) are thought to be associated with increased mortality in elderly patients. Low retinol-binding protein-4 (RBP4) is associated with a high risk of respiratory infections in the general population. Therefore, we hypothesized that low RBP4 levels are associated with an increased risk of AECOPD and can be used as a biomarker for AECOPD in elderly patients.MethodsEnzyme-linked immunosorbent assays were used to assess RBP4 levels in elderly with AECOPD within the first 24 hours after intensive care unit admission. Forty-six elderly patients with stable COPD in outpatient clinics and 50 healthy elderly persons who had physical examinations as outpatients were controls.ResultsIn AECOPD patients, RBP4 levels were lower than those in stable COPD patients and healthy controls (59.7 vs 91.2 and 113.6 mg/L, p < 0.001). RBP4 levels were decreased by 30.6% in non-survivors compared with survivors (51.5 vs 74.2 mg/L, p < 0.001). A higher Acute Physiology and Chronic Health Enquiry II (APACHE II) score and Simplified Acute Physiology score (SAPS II) were associated with lower RBP4 levels (r = −0.692, p = 0.024 and r = −0.670, p = 0.015, respectively). RBP4 was positively correlated with creatinine and body mass index, and negatively correlated with C-reactive protein and Global Initiative for Chronic Obstructive Lung Disease stage. Multivariate logistic regression showed that RBP4 was an independent mortality predictor of AECOPD (odds ratio: 0.926, p = 0.007). Analysis of the area under the receiver operating characteristic (AUC) curve showed that RBP4 showed good discrimination (AUC: 0.88; 95% confidence interval: 0.78–0.94; p = 0.008) in predicting mortality. RBP4 improved the prognostic accuracy of mortality for the APACHE II and SAPS II scores.ConclusionsSerum RBP4 levels are significantly reduced in elderly AECOPD patients. RBP4 might be a good predictive biomarker for mortality in elderly AECOPD patients in the intensive care unit.

【 授权许可】

Unknown   
© Jin et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.