Study On The Correlation Of Blood Uric Acid,Leptin,Retinol Binding Protein 4 With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objects:The study aims to explore the correlation of blood uric acid,leptin,retinol binding protein 4(RBP4)with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)which severity of lung function,tissue hypoxia degree and inflammatory response.We also explore the possible correlation of blood uric acid,leptin and RBP4 with nutritional status in AECOPD patients,reveal the role and clinical value of blood uric acid,leptin and RBP4 in AECOPD patients.Methods:A total of 138 AECOPD patients admitted to the Department of Respiratory and Critical Care Medicine of the First Affiliated Hospital of Xi’an Medical College from May 2020 to November 2020 were selected as the AECOPD group,and 66 healthy adults from the physical examination center during the same period were selected as the control group.We collected clinical datas such as age,gender,body mass index(BMI),and serum samples for all groups of people in the two groups to determine the levels of blood uric acid,leptin,and RBP4 in the two groups.We also determined the C-reaction protein(CRP),lung function,and partial pressure of oxygen in arterial blood(PaO2)in AECOPD patients.Shapiro-Wilk(W test),c2 test,t test,one-way ANOVA,Mann-Whitney test,Kruskal-Wallis test,Spearman correlation analysis were used for statistical analysis.There were statistical differences at p<0.05,and significant statistical differences at p<0.01.The study compared the levels of blood uric acid,leptin,and RBP4 between the AECOPD group and the control group;then divided the AECOPD group into mild,moderate,severe,and extreme according to lung function,and explored the level of blood uric acid,leptin,RBP4 in different severity of lung function of AECOPD patients.Further exploreing the correlation of uric acid,leptin,RBP4 with PaO2 and CRP respectively.Finally,the AECOPD group patients were divided into obese group,overweight group,normal group,and wasting group according to BMI.We explored the possible correlation of the uric acid,leptin,RBP4 and the nutritional status of AECOPD patients.Results:1.This study included 138 patients in the AECOPD group and 66 patients in the control group.There were no statistical differences in gender composition and age between the two groups(p>0.05).2.The uric acid level of the AECOPD group was 326.50(265.50-380.50)umol/L,and the uric acid level of the control group was 299.50(275.75-322.75)umol/L.The leptin level of the AECOPD group was 17.13(13.33-20.40)ng/m L,and the control group was 10.04(7.91-11.95)ng/m L.The RBP4 level in the AECOPD group was51.90(42.01-63.15)μg/m L,and the RBP4 level in the control group was 42.79(37.28-50.86)μg/m L.The levels of uric acid,leptin and RBP4 in the AECOPD group were higher than those in the control group.There were statistical differences in the levels of uric acid between the two groups(p<0.05),and there were significant statistical differences in the levels of leptin and RBP4(p<0.01).3.The uric acid levels of patients in the AECOPD group with mild,moderate,severe,and very severe lung function were 225.00(186.50-248.50)umol/L,284.50(247.25-321.25)umol/L,348.00(300.00-372.00)umol/L,397.00(298.00-486.00)umol/L.Le ptin levels were 13.12±2.45ng/m L,15.70±3.93ng/m L,16.81±4.26ng/m L,18.11±4.67ng/m L,and RBP4 levels were 45.01±14.58 μg/m L,46.17±12.93 μg/m L,56.09±12.61μg/m L,58.48±14.04μg/m L.There were significant statistical differences in the levels of uric acid and RBP4 in AECOPD patients with different pulmonary function classifications(P<0.01),and there were statistical differences in the levels of leptin between the groups(P<0.05).4.Blood uric acid level was positively correlated with CRP(r=0.196,P=0.021);RBP4level was positively correlated with CRP(r=0.226,P=0.008);There was no significant correlation between leptin level and CRP,so were between uric acid level,leptin level,RBP4 level and PaO2(p>0.05).5.Blood uric acid values of patients in the obesity group,overweight group,normal group,and wasting group in the AECOPD group were 318.00±92.61umol/L,299.03.00±64.73umol/L,331.00±77.22umol/L,369.00±96.59umol/L,so there were significant statistical differences between the groups in blood uric acid(P<0.01).There were no statistical difference in the leptin and RBP4 levels(P>0.05).Conclusions:1.The levels of blood uric acid,leptin and RBP4 in the AECOPD group were higher than those in the control group.The blood uric acid,leptin and RBP4 may have a certain relationship with the occurrence of AECOPD.2.As the severity of lung function increases,the levels of blood uric acid,leptin and RBP4 show an increasing trend.The three factors can be used as indicators to assist in evaluating the severity of lung function in patients with AECOPD.3.Blood uric acid and RBP4 levels can be used as reference indicators for evaluating the inflammation in patients with AECOPD.4.There were no correlation of blood uric acid,leptin,RBP4 levels with PaO2.When assessing the degree of hypoxia,it is recommended to use traditional arterial blood gas analysis.5.Monitoring blood uric acid level can assist in evaluating the nutritional status and prognosis of AECOPD patients,especially when it is inconvenient to measure BMI in critically ill patients.