Study On The Significance Of Human Serum Fetuin-A In Chronic Obstructive Pulmonary Disease

Objective:To investigate the changes of serum Fetuin-A levels in patients with chronic obstructive pulmonary disease(COPD)in different stages of disease and different lung function and the correlation with serum hypervolemia(hs-CRP)and interleukin-6(IL-6)and their clinical significance.Methods:Select the Affiliated Hospital of Southwest Medical University in October 2015 to October 2016 Department of Respiratory Medicine in patient department diagnosed with acute exacerbation of COPD in 50 patients as acute exacerbation of COPD group.All patients were stable for 6 weeks and followed up as COPD stable group after relieved and discharged(Plan to observe 60 cases,2 cases automatically discharged and 8 cases no reason to fall off in the study process and 50 cases were included in the study finally).According to the number of last year acute exacerbations,the stable COPD patients were divided into two groups,of which the last year acute exacerbations?2 times(frequent acute exacerbations group)patients was a total of 28 cases(54%),and the last year acute exacerbations<2 times(non-frequent acute exacerbations group)patients was a total of 22 cases(44%).According to the classification of lung function,the stable COPD patients were divided into three groups:GOLD ?(mild):6 cas-es(12%),GOLD ?(moderate):22 cases(44%),GOLD ?-?(severe-very severe):22 cases(44%).In the same period,a total of 30 healthy subjects were selected from the medical examination center as the control group.All patients were tested the pulmonary function,collected age,sex,height,weight,smoking status and other information,collected serum separated from fasting venous blood after centrifugation.The levels of serum Fetuin-A,hs-CRP,IL-6 were measured by enzyme-linked immunosorbent assay(ELISA).SPSS 18.0 statistical software for data processing and statistical analysis.Results:1.Serum Fetuin-A expression levels:Serum Fetuin-A concentration in acute exacerbation of COPD(333.5(267.5-397.3)ug/mL)was lower than that in stable group(406.9(353.6-455.9)ug/mL)(P<0.001),the acute exacerbation group and the stable group were lower than that in the control group(449.4(384-501.6)ug/mL)(P<0.001);The frequent acute exacerbations group(369(337.5-442.8)ug/mL)was lower than that in the non-frequent acute exacerbations group(451(388.7-484.6)ug/mL)(P=0.008);Pulmonary function grade ?-? group((356.2(330-410.4)ug/mL)was lower than that in lung function grade ? group(440.9(364.3-461.5)ug/mL)(P=0.007),and pulmonary function grade ? group was lower than that in pulmonary function grade ?group(530.1(474.2-552.2)ug/mL)(P=0.001).2.Serum hs-CRP,IL-6 expression levels:The levels of serum hs-CRP in the acute exacerbation group(34.5(22.1-62.2)mg/L)was higher than those in the stable group(10.3(4.7-13.8)mg/L)(P<0.001),and the acute exacerbation and stable group were higher than the contrl group(5.6(3.5-9.1)mg/L)(P<0.001).The levels of serum IL-6 in the acute exacerbation group(353.6(317.2-370.8)pg/mL)was higher than those in the stable group(246.8(220.3-283)pg/mL)(P<0.001),and the acute exacerbation and stable group were higher than the control group(182.3(151.8-212.1)pg/mL)(P<0.001).3.Correlation between serum levels of Fetuin-A and COPD in patients withs table COPD:The serum Fetuin-A concentration in patients with stable phase was positively correlated with FEV1%,FVC%,FEF25-75%and FEV1/FVC(FEV1%r=0.55,P<0.001;VC%r = 0.3 9 5,P = 0.005;FEF 25-75%r = 0.426,P=0.022,FEV1/FVC r=0.377,P=0.007),compared with the modified version of the British Medical Research Council dyspnea questionnaire(mMRC questionnaire)score and serum IL-6 concentration,serum hs-CRP concentration was negatively correlated(mMRC score r=-0.399,P?0.004;IL-6 r=-0.361,P=0.01;hs-CRP r=-0.562,P<0.001).Conclusion:1.The levels of serum Fetuin-A may help identify patients with acute exacerbations of COPD and may predict the risk of future acute exacerbations.2.The levels of serum Fetuin-A may be associated with COPD airflow severity,the lower the lung function,the lower the serum Fetuin-A concentration.3.Serum Fetuin-A is a negative regulatory protein and may have anti-inflammatory effects in patients with COPD.