Diagnostic Value And Significance Of Serum FSTL1 And Gal-3 In Patients With AECOPD

Objective:The levels of serum FSTL1 and Gal-3 in patients with Acute exacerbation of chronic obstructive pulmonary disease（Acute exacerbation of chronic obstructive pulmonary disease,AECOPD）,stable chronic obstructive pulmonary disease（Chronic obstructive pulmonary disease,SCOPD）,and healthy controls were compared,to analyze the correlation between serum FSTL1,Gal-3,and inflammatory indexes（WBC,NEU%,CRP,PCT）,pulmonary function indexes（FEV₁,FEV₁/FVC,FEV₁/pred%）.To explore the diagnostic value of serum FSTL1,Gal-3in patients with AECOPD.Methods:1.Sixty-two patients with AECOPD who were hospitalized in the Department of Respiratory Medicine of the First Affiliated Hospital of Gannan Medical University from December 1st,2021 to November 30th,2022 were collected（AECOPD group）.The AECOPD group was divided into three subgroups according to the severity of airflow limitation（GOLD grade）:mild to moderate（FEV₁%pred≥50%）,severe（30%≤FEV₁%pred<50%）and very severe（FEV₁%pred<30%）.The patients in the AECOPD group were divided into AECOPD alone group and AECOPD with chronic pulmonary heart disease group.Nineteen patients with SCOPD（SCOPD group）were collected after active anti-infection,sputum relief,antispasmodic,and asthma treatment and hospitalization for more than 7 days,and their condition had significantly improved to meet the discharge criteria or outpatient review.During the same period,63 cases were collected from healthy individuals who had been examined at the First Affiliated Hospital of Gannan Medical University or the community health service center of Nanwai Street in Ganzhou.2.General information on the study subjects such as gender,age,height,weight and whether they smoked,as well as laboratory indices such as WBC,NEU%,CRP,PCT and lung function indices of the study subjects,and peripheral blood was collected and serum FSTL1and Gal-3 concentrations of the study subjects were measured by Double antibody sandwich method（ELISA）.3.Statistical analysis using SPSS 25.0,the differences of serum FSTL1 and Gal-3expression among the AECOPD group,SCOPD group,and the healthy group were compared,and the differences of serum FSTL1 and Gal-3 expression among different subgroups in AECOPD group were also compared.The correlation of FSTL1,Gal-3 with WBC,NEU%,CRP,PCT and pulmonary function was analyzed in the AECOPD group;Drawing receiver operating characteristic curves（ROC curves）to compare the area under the ROC curve（AUC）of serum FSTL1 and Gal-3 for AECOPD diagnosis alone and incombination,to investigate the diagnosticvalueof serum FSTL1,Gal-3 andtheir combination in AECOPD.Results:1.Serum FSTL1 and Gal-3 levels were statistically different in the AECOPD,SCOPD and healthy groups.serum FSTL1 and Gal-3 levels were higher in the AECOPD group than in the SCOPD group（P<0.05）and inthe SCOPDgroup than inthe healthy group（P<0.05）.2.Spearman correlation analysis showed that the serum FSTL1 levels in the AECOPD group were positively correlated with CRP（r=0.338,P<0.05）,not significantly correlated with WBC,NEU%,and PCT（P>0.05）,and negatively correlated with FEV₁,FEV₁/FVC,and FEV₁%pred（r in order is-0.386,-0.520,and-0.583,P<0.05）.Serum Gal-3 levels in the AECOPD group were positively correlated with CRP（r=0.375,P<0.05）,not significantly correlated with WBC,NEU%,PCT（P>0.05）,and negatively correlated with FEV₁,FEV₁/FVC,FEV₁%pred（rin order is-0.560,-0.629,-0.809,P<0.05）.3.In the AECOPD group,the serum FSTL1 and Gal-3 levels in the extremely severe group with GOLD grading were higher than those in the severe group（P<0.05）,and the serum FSTL1 and Gal-3 levels in the severe group were higher than those in the mild and moderategroup（P<0.05）.4.The ROC curve showed that the area under the curve（AUC）of serum FSTL1 in diagnosing AECOPD is 0.935（P<0.05）,Yoden index is 0.765,the best diagnostic value is53.07ng/ml,sensitivity is 0.887,specificity is 0.878.The AUC of serum Gal-3 in diagnosing AECOPD is 0.923（P<0.05）,Yoden index is 0.712,the best diagnostic value is 10.13ng/ml,sensitivity is 0.871,specificity is 0.8.The AUC of serum FSTL1 combined with Gal-3 in the diagnosis of AECOPD is 0.952（P<0.05）,Yoden index is 0.782,sensitivity is 0.806,specificity is 0.976.Conclusion:1.Serum FSTL1 and Gal-3 expression levels were elevated in SCOPD patients and more pronounced in AECOPD patients.2.In the AECOPD group,Serum FSTL1 and Gal-3 expression levels increased with the increase of GOLD grading,which has certain clinical significance for evaluating the severity of thedisease inpatients with AECOPD.3.Serum FSTL1 and Gal-3 have certain diagnostic value for AECOPD,and the efficacy ofcombined diagnosis is betterthan that of singlediagnosis.