Assessment of serum Retinol-Binding Protein-4 Levels in patients with acute exacerbation of chronic obstructive disease at intensive care unit

Abstract

BackgroundChronic obstructive pulmonary disease (COPD) is a major cause of mortality and morbidity. Retinol-Binding Protein 4 (RBP4), has been recognized as an adipokine implicated in COPD. In this study we assessed the level of serum RBP4 in patients with acute exacerbation of COPD (AECOPD) at intensive care unit and compared to stable patients and healthy controls. ObjectiveAssessment of serum RBP4 in patients with AECOPD at intensive care unit and the possibility of its use as a predictive biomarker for mortality in AECOPD. Patients and methodThis study was conducted on Ninety persons divided into 3 groups: Group 1: Forty patients with AECOPD admitted to ICU. Group 2: Thirty patients with stable COPD. (Group 1 and 2 were classified according to Global Initiative for COPD (GOLD, 2015). Group 3: Twenty healthy persons as a control. They were subjected to full history taking, clinical examination, Investigations as liver and kidney functions and serum RBP4 assessment by Enzyme-linked immunosorbent assays.Samples were collected within first 24 h of admission. ResultsThere was a significant decrease in serum RBP4 in patients with AECOPD (mean 71.73 ± 33.43) mg/L admitted in ICU than other 2 groups: stable COPD (mean 177.53 ± 93.24) mg/L and healthy controls (mean 231.21 ± 122.90) mg/L and further decrease in non survivors (mean 48.57 ± 16.26) mg/L than survivors (mean 106.46 ± 18.85) mg/L. (Z = 5.301, p ≤ .001). RBP4 was positively correlated with body mass index and serum albumin, while negatively correlated with serum creatinine, c reactive protein, total bilirubin and APACHE-II score. ConclusionSerum-Retinol-Binding Protein-4 can be used as a predictive biomarker for mortality in AECOPD. We recommend that the serum RBP4 should be taken in consideration as a part of the assessment of mortality of AECOPD patients admitted in ICU.