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

Abstract

Background

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

Ethics Approval and Informed Consent

The research was approved from the Ethics Committee of the Third Hospital of Shanxi Medical University, Written informed consents were obtained from all participants. This study was conducted in accordance with the Declaration of Helsinki.

Author Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Jing Yan, Yajing Duan and Mengyu Cheng. The first draft of the manuscript was written by Jing Yan and Mengyu Cheng and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript and have agreed on the journal to which the article has been submitted. All authors agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

Funding was provided by the Natural Science Foundation of Shanxi Province (No. 201901D111414). Funding was provided by the Research Project Supported by Shanxi Scholarship Council of China (No. 2020-178). Funding was provided by the Fund Program for the Scientific Activities of Selected Returned Overseas Professionals in Shanxi Province (No. 20200029).Funding was provided by the Tianjin Medical Construction of Key Discipline (Specialty) Funded Project (TJYXZDXK-013A).