Prognostic Value of Serum Growth Differentiation Factor-15 in Patients with Chronic Obstructive Pulmonary Disease Exacerbation.
10.4046/trd.2014.77.6.243
- Author:
Miyoung KIM
1
;
Seung Ick CHA
;
Keum Ju CHOI
;
Kyung Min SHIN
;
Jae Kwang LIM
;
Seung Soo YOO
;
Jaehee LEE
;
Shin Yup LEE
;
Chang Ho KIM
;
Jae Yong PARK
;
Dong Heon YANG
Author Information
1. Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea. sicha@knu.ac.kr
- Publication Type:Original Article
- Keywords:
Pulmonary Disease, Chronic Obstructive;
Disease Progression;
Growth Differentiation Factor 15;
FABP3 Protein, Human
- MeSH:
Disease Progression;
Growth Differentiation Factor 15;
Humans;
Intubation, Intratracheal;
Mortality;
Multivariate Analysis;
Prospective Studies;
Pulmonary Disease, Chronic Obstructive*
- From:Tuberculosis and Respiratory Diseases
2014;77(6):243-250
- CountryRepublic of Korea
- Language:English
-
Abstract:
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. 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.
