Tuberc Respir Dis.  2014 Dec;77(6):243-250. 10.4046/trd.2014.77.6.243.

Prognostic Value of Serum Growth Differentiation Factor-15 in Patients with Chronic Obstructive Pulmonary Disease Exacerbation

• Kim M
• Cha SI
• Choi KJ
• Shin KM
• Lim JK
• Yoo SS
• Lee J
• Lee SY
• Kim CH
• Park JY
• Yang DH

• KMID: 1842991
• DOI: http://doi.org/10.4046/trd.2014.77.6.243

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 PaCO2>37 mm Hg were significantly higher in the adverse outcome group (mental change: 30% vs. 6%, p=0.034 and PaCO2>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 PaCO2>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 PaCO2>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.

Keyword

Pulmonary Disease, Chronic Obstructive; Disease Progression; Growth Differentiation Factor 15; FABP3 Protein, Human

MeSH Terms

Disease Progression
Growth Differentiation Factor 15
Humans
Intubation, Intratracheal
Mortality
Multivariate Analysis
Prospective Studies
Pulmonary Disease, Chronic Obstructive*
Growth Differentiation Factor 15

Figure

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  Figure 1 Causes of chronic obstructive pulmonary disease exacerbation. The most common cause was tracheobronchitis (60% [n=6] in the adverse outcome group and 69% [n=60] in the control group, respectively), followed by pneumonia (30% [n=3] in the adverse outcome group and 22% [n=19] in the control group, respectively).

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