The Expression Of Myostatin?Smad3and Murf-1in Peripheral Serum Of Patients With Chronic Obstructive Pulmonary Disease Combined With Pulmonary Hypertension

Objective To detect the expression level of Myostatin,Smad3,MuRF-1 in peripheral serum of patients with chronic obstructive pulmonary disease(COPD),patients with chronic obstructive pulmonary disease combined with pulmonary hypertension(PH)and healthy volunteers,and explore the diagnostic value of expression level to chronic obstructive pulmonary disease combined with pulmonary hypertension.Methods We collected 62 cases of stable COPD patients,which were divided into 31 with COPD and 31 with COPD combined with PH by the results of echocardiography,from Respiratory and Critical Medicine of General Hospital of Ningxia Medical University and from January 2018 to December 2018.At the same time,27 cases of healthy examination people were collected as the normal control group.We collected general information of the three groups,such as gender,age,smoking index,lung function and so on.Measured the concentrations of Myostatin ? Smad3 and MuRF-1 in peripheral serum by enzyme-linked immunosorbent assay(ELISA).Drew the receiver operating characteristic(ROC)curves,calculated the indicators of three factors,and evaluated their diagnostic value of separate tests and other parallel tests.Results 1.General information:(1)The pairwise comparison of COPD combined with PH group,COPD group and normal control group had significant statistical differences in age,sex,smoking index and lung function(P<0.01).(2)The CAT score and mMRC score in the COPD merged with PH group were significantly higher than that of COPD group,all thedifferences were statistically significant(P<0.01).(3)The main pulmonary artery diameter,the right ventricular diameter,the right ventricular outflow tract,the horizontal diameter and longitude diameter of right atrium in the COPD merged with PH group and COPD group had significant statistical differences(P<0.01).There was no significant difference between the COPD group and the normal control group(P>0.05).2.Expression level:(1)The concentrations of Myostatin?Smad3?MuRF-1 level in the COPD merged with PH group were significantly higher than that of COPD group and the normal control group,there were statistically significant of all differences(P<0.01).(2)The concentrations of Myostatin?Smad3?MuRF-1 level of the COPD group were significantly higher than that of the normal control group,there were statistically significant of all differences(P<0.01).3.Diagnostic value:(1)The areas under ROC curve of Myostatin?Smad3 and MuRF-1 were0.918,0.836 and 0.864,respectively.The cut-off values were 254.53pg/ml,4.09ng/ml and381.26pg/ml.The sensitivity were 93.5%,64.5% and 74.2% and the specificity were 80.6%,77.4%,77.4%,respectively.(2)The sensitivity and specificity of parallel detection of Myostatin and Smad3 were 93.5% and 67.7%,respectively;in the parallel test of Myostatin and MuRF-1,the sensitivity and specificity were 96.8% and 71.0% respectively;the sensitivity and specificity of parallel detection of MuRF1 and Smad3 were 80.6% and 67.7%,respectively;the sensitivity of the parallel test of Myostatin,MuRF-1 and Smad3 was 96.8%,and specificity was 64.5%.Conclusion : 1.The levels of Myostatin,Smad3 and MuRF-1 in peripheral blood of patients with COPD merged with PH are significantly higher than those of COPD and healthy patients.They have certain reference value in assisting diagnosis of COPD merged with PH.2.Compared with Smad3 and MuRF-1,Myostatin have relatively higher areas under the ROC curve and sensitivity for the diagnosis of COPD merged with PH,and it is expected to be a new indicator for early identification of COPD and COPD merged with PH.3.The parallel test of Myostatin and MuRF-1 can improve the sensitivity of detection,it is suggested that the combined detection of the two is of great value in the diagnosis of COPD combined with PH.