Clinical Diagnostic Value of Serum GABA, NE, ET-1, and VEGF in Chronic Obstructive Pulmonary Disease with Pulmonary Hypertension

Abstract

Jing Yan,1,* Yajing Duan,2,* Mengyu Cheng3,4 1Department of Respiratory and Critical Care Medicine, Lvliang People’s Hospital Affiliated to Shanxi Medical University, Lvliang City, Shanxi Province, 033000, People’s Republic of China; 2Department of Intensive Care Unit, Key Laboratory for Critical Care Medicine of the Ministry of Health, Emergency Medicine Research Institute, Tianjin First Center Hospital, Nankai University, Tianjin, 300192, People’s Republic of China; 3Department of Respiratory and Critical Care Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030032, People’s Republic of China; 4Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People’s Republic of China*These authors contributed equally to this workCorrespondence: Mengyu Cheng, Department of Respiratory and Critical Care Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, No. 99, Longcheng Street, Taiyuan, Shanxi, People’s Republic of China, Tel [phone], Email [email protected]: Pulmonary hypertension (PH) is the one of the most common complications of chronic obstructive pulmonary disease (COPD). Whereas, the associated diagnostic factors are uncertain. The present study aims to investigate useful diagnostic factors in patients with COPD and PH (COPD-PH).Patients and Methods: A total of 111 patients with COPD in Shanxi Bethune Hospital from December 2019 to December 2020 were divided into COPD (PASP≤ 50 mmHg) and COPD-PH groups (PASP> 50 mmHg). Pulmonary function and chest CT results were collected. Routine blood, biochemical, and blood coagulation function indices were examined for all patients. Arterial blood gas analysis and serum cytokines were also measured. Differences in the distribution of the above indicators between the two groups were analyzed using binary logistic regression analysis to identify the risk factors of COPD-PH, and multiple linear regression analysis to determine the factors affecting PASP. The influencing factors and joint predictive factors of the above linear regression analysis were analyzed using the ROC curve. The area under the curve and the best cut-off value were calculated, and their predictive value and clinical significance in disease diagnosis were discussed.Results: A total of 27 indexes with statistically significant differences between the two groups were identified (P < 0.05). Binary Logistic regression analysis showed that the factors influencing the diagnosis of pulmonary hypertension were serum GABA, NE, VEGF, BUN, and LYM% levels (P < 0.05). Multiple linear regression showed that the factors influencing PASP were serum NE, ET-1, GABA, and VEGF levels, and the goodness of fit of the model was 0.748 (P < 0.001). ROC curve showed that the AUC of the combined diagnosis of serum NE, ET-1, GABA, and VEGF levels was 0.966 (sensitivity, 87.5%; specificity, 93.65%).Conclusion: Serum NE and ET-1 are risk factors for COPD-PH, whereas serum GABA and VEGF are protective factors against COPD-PH. The combined diagnostic value of serum NE, ET-1, GABA, and VEGF levels was the highest.Keywords: diagnosis, chronic obstructive pulmonary disease, pulmonary hypertension, cytokine

Keywords

• diagnosis
• chronic obstructive pulmonary disease
• pulmonary hypertension
• cytokine