The Expression Of Serum SRAGE And MMP-9 And Its Clinical Significance In The COPD With Diabetes Mellitus Patients

Objective:To investigate the expression of matrix metalloproteinases(MMPs)-9,soluble receptor for advanced glycation end-products(sRAGE)and which were correlated with COPD assessment(CAT),the number o f acute exacerbations,HRCT phenotype in chronic obstructive pulmonary disease(COPD)with diabetes mellitus(DM)patients.Methods: 76 COPD patients hospitalized in our department from January2017 to November 2017 were enrolled the study.All COPD patients were divided into two groups based on whether or not diabetes mellitus was combined,they were observation group and control group,respectively.Patients in the former group included the COPD with DM patients,and the latter group did not combine with DM.Lung function,CAT and the number of acute exacerbations in the last year were recorded in detail.All patients underwent chest HRCT(divided into emphysema phenotype and airway inflammation phenotype),and the fasting blood was extracted for routine examination.Serum sRAGE and MMP-9 were measured by enzyme-linked immunosorbent assay(ELISA).SPSS 23.0 software was used to analyze the data.Results:1.The level of sRAGE was significantly higher in the observation group(1415.64(1279.91-1692.2)pg/mL)than the control group(937.98(806.06-1269.16)pg/mL)(P<0.05).2.The level of sRAGE of inflammatory phenotype in the observation group(1688.63(1342.42-2099.14)pg/mL)was higher than that in the control group(1176.47(850.26-1322.31)pg/mL),and the difference was statistically significant(Z=-3.46,P=0.001).The level of s RAGE of the emphysema phenotype in the observation group(1290.11(800.77-1614.65)pg/mL)washigher than that in the control group(896.8(743.62-1268.23)pg/mL),but the difference was not statistically significant(Z=-1.41,P=0.16).The level of sRAGE in the airway inflammatory phenotype(1688.63(1342.42-2099.14)pg/mL)was higher than that in the emphysema phenotype(1290.11(800.77-1614.65)pg/mL)in the observation group,and the difference was statistically significant(Z=-2.51,P=0.012).3.The level of MMP-9 in the observation group(132.42(122.21-144.43)ng/mL)and the control group(129.29(121.7-137.9)ng/mL)was not statistically significant(P > 0.05).4.The level of MMP-9 of inflammatory phenotype in the observati on group(135.18(113.92-142.72)ng/mL)was higher than that in the contr ol group(125.72(119.42-131.98)ng/mL),but the difference was not statisti cally significant(Z=-0.59,P=0.56).The level of MMP-9 of the emphys ema phenotype in the observation group(131.36(126.68-152.09)ng/mL)a nd the control group(133.28(123.25-142.49)ng/mL)was not statistically significant(Z=-0.29,P=0.77).5.There was a significant correlation between the level of serum sRAGE and the level of serum MMP-9 in the inflammatory phenotype of the observation group(r=0.73,P=0.017).There was no correlation between the two inflammatory factors in the inflammatory phenotype of the control group(r=0.02,P=0.96).6.The percentage of neutrophils in the observation group was higher than that in the control group(P<0.05),and the level of s RAGE was positively correlated with the percentage of neutrophils(r=0.47,P=0.014).No correlation was found in the control group(P>0.05).7.The level of serum sRAGE in the observation group and control group was not correlated with CAT,the number of acute aggravation in the last year,and FEV1%(r=0.20,0.16,-0.20,0.139,0.071,0.199,P>0.05).The level of serum MMP-9 in the observation group and control group was not correlated with neutrophil percentage,CAT,the number of acute aggravation in the last year,and FEV1% neutrophil percentage(r=-0.10,-0.103,0.066,0.129,0.251,-0.044,0.134,-0.109,P>0.05).Conclusion:1.The level of s RAGE in COPD with diabetes patients was increased,especially in the airway inflammatory phenotype,which may be one of the inflammatory biomarkers of COPD with diabetes mellitus patients.2.MMP-9 was involved in the pathogenesis of sRAGE expression in the airway inflammatory in the COPD and diabetes mellitus patients,but it was not related to the emphysema phenotype in the COPD and diabetes mellitus patients.In summary,the pathogenesis of COPD with diabetes mellitus is more complex,and s RAGE and MMP-9 are involved in the pathogenesis of some of the inflammatory response,which may has clinical value for clinical subgroup evaluation.