| Objective:(1)To detect the level of serum Fetuin-A,serum hypersensitive C-reactive protein(Hs-CRP),serum tumor necrosis factor α(TNF-α)and carotid intima-media thickness(CCA-IMT)in patients with Chronic Obstructive Pulmonary Diseases(COPD)coexist with Cardiovascular Disease(CVD).(2)To study the correlation between serum Fetuin-A and parameters including age,sex,body mass index,smoking index,current smoking status,blood lipid,and serum CCA-IMT,TNF-α,Hs-CRP in patients with COPD coexist with CVD.(3)To evaluate the clinical value of serum Fetuin-A used to assess the diagnostic value of COPD patients coexist with CVD.Methods Altogether 52 COPD patients coexist with CVD(COPD + CVD group),36 COPD patients(COPD group),34 CVD patients(CVD group)which were diagnosed in the Department of Respiratory and Cardiovascular Medicine,affiliated Hospital of Southwest Medical University from September 2015 to May 2017.And 40 healthy adults in Health examination Center of affiliated Hospital of Southwest Medical University as control group.Age,sex,body mass index,smoking status,fasting blood lipid were collected before admission.After each group of patients was stable after treatment,the patients met the criteria of stable phase.4 ml of fasting venous blood was taken from the patients in each group,and the serum was collected after centrifugation.Serum Fetuin-A,Hs-CRP and TNF-α levels were detected by enzyme-linked immunosorbent assay(ELISA),to measure CCA-IMT by carotid Ultrasound.Use spss17.0 statistical software for data processing and statistical analysis.Results(1)There was no statistical difference between the general data of each group included age,sex,body mass index,smoking index,current continuous smoking,and blood lipids(all P>0.05).(2)The expression level of serum Fetuin-A in each group: Compared with the healthy control group(90.0(69.2-105.7)ng/ml),Serum Fetuin-A concentration all decreased in CVD group(51.3(40.6-63.1)ng/ml),COPD group(50.1(41.8-61.2)ng/ml),and COPD+CVD group(38.3(23.7-56.0)ng/ml),(all P<0.01).The serum Fetuin-A level in COPD+CVD group was significantly lower than that in COPD and CVD groups,(both P<0.01).(3)The expression of CCA-IMT and serum TNF-α,serum Hs-CRP in each group: CCA-IMT in CVD group(0.74±0.18)mm,COPD group(0.74±0.18)mm,and COPD+CVD group(0.94±0.14)mm,were thicker than that in healthy control group(0.65±0.13)mm,(all P<0.05).CCA-IMT was thicker in COPD+CVD group than that in CVD group and COPD group(both P<0.001).The serum levels of TNF-α and Hs-CRP in CVD group[(2.82±0.34)pg/ml、(90.1(89.6-115.3)mg/ml)],COPD group[(2.88±0.87)pg/ml、(119.2(86.4-148.9)mg/ml)],COPD+CVD group[(3.19±0.38)pg/ml、(152.3(117.1-174.3)mg/ml)] were higher than those in healthy control group[(2.41±0.87)pg/ml、(13.9(8.7-81.4)mg/ml)],(all P<0.05).The serum levels of TNF-α and Hs-CRP in COPD+CVD group were significantly higher than those in CVD group and COPD group,(all P<0.001).(4)Correlation among serum Fetuin-A and parameters of COPD coexist with CVD: There was no correlation among serum Fetuin-A and age,sex,body mass index,smoking index,current smoking status,blood lipid(all P>0.05)).There was significant negative correlation among Fetuin-A and CCA-IMT(r =-0.490,P <0.01),TNF-α(r=-0.326,P<0.05),Hs-CRP(r=-0.519,P<0.01).(5)Analysis of COPD patients and COPD coexist with CVD patients,The area under ROC curve(AUC)of serum Fetuin-A concentration was 0.807(95%CI:0.717-0.897,P < 0.001),when the Youden index the maximum(0.537),the serum Fetuin-A was 40.8ng/ml,at the moment the sensitivity is 0.806,the specificity is 0.731.Conclusion 1.Serum Fetuin-A may be involved in the inflammatory process of COPD coexist with CVD disease,and has a decreased expression in patients with COPD coexist with CVD.2.Serum Fetuin-A is helpful for clinical identification of COPD patients coexist with CVD.As a biomarker,which has a potential clinical evaluation value for whether COPD is coexist with CVD.When serum Fetuin-A value is lower than 33.7 ng / ml,COPD patients are more likely to be coexist with CVD. |
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