Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Prognostic Value of Serum Growth Differentiation Factor-15 in Patients with Chronic Obstructive Pulmonary Disease Exacerbation

  • Kim, Miyoung (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Cha, Seung-Ick (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Choi, Keum-Ju (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Shin, Kyung-Min (Department of Radiology, Kyungpook National University School of Medicine) ;
  • Lim, Jae-Kwang (Department of Radiology, Kyungpook National University School of Medicine) ;
  • Yoo, Seung-Soo (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Lee, Jaehee (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Lee, Shin-Yup (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Kim, Chang-Ho (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Park, Jae-Yong (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Yang, Dong Heon (Department of Internal Medicine, Kyungpook National University School of Medicine)
  • Received : 2014.07.02
  • Accepted : 2014.09.16
  • Published : 2014.12.31
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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 $PaCO_2$>37 mm Hg were significantly higher in the adverse outcome group (mental change: 30% vs. 6%, p=0.034 and $PaCO_2$>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 $PaCO_2$>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 $PaCO_2$>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.

Keywords

References

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