Abstract

Background/aim The serum fatty acid binding protein 4 (FABP-4) level increases in chronic inflammatory diseases. The present study aimed to examine serum FABP-4 and interleukin (IL)-6 levels in patients with stable and acute exacerbation of chronic obstructive pulmonary disease (COPD) and the correlation of these markers with airflow limitation.Materials and methods We measured serum FABP-4 and IL-6 levels in 60 COPD patients [30 stable COPD (SCOPD), and 30 acute exacerbation of COPD (AECOPD)], and 30 healthy subjects and compared them with airflow limitation according to the COPD stage in the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) criteria, peripheral O2 saturation (SpO2), and COPD Assessment Test (CAT) score. We also tested the association between serum FABP-4 levels and some characteristics of study parameters. Results Both serum FABP-4 and IL-6 levels increased with increasing severity of GOLD grades in SCOPD (P < 0.01 for both) and AECOPD groups (P < 0.001 and P < 0.01, respectively). It also increased in patients with AECOPD group compared with SCOPD group in GOLD grades I-II (P < 0.01) and GOLD grades III-IV (P < 0.05). In addition, there was a significant positive correlation between serum FABP-4 level with IL-6, CAT score, and smoking history and inversely with FEV1 and SpO2. Conclusion The study revealed that serum FABP-4 level was elevated with increasing GOLD grades in COPD patients, markedly in acute exacerbation phase. The increase was associated with elevated serum levels of IL-6 and severity of hypoxia. Thus, it seems that FABP-4 may be involved in the pathogenesis of COPD.

Highlights

  • Chronic obstructive pulmonary disease (COPD) is one of the diseases that deeply affects morbidity and mortality in the world [1]

  • Both serum fatty acid binding protein 4 (FABP-4) and IL-6 levels increased with increasing severity of Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) grades in stable COPD (SCOPD) (P < 0.01 for both) and acute exacerbation of COPD (AECOPD) groups (P < 0.001 and P < 0.01, respectively)

  • It increased in patients with AECOPD group compared with SCOPD group in GOLD grades I-II (P < 0.01) and GOLD grades III-IV (P < 0.05)

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Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is one of the diseases that deeply affects morbidity and mortality in the world [1]. Acute exacerbation of COPD (AECOPD) is characterized by increased systemic inflammation, worsening of pulmonary function tests, increased sputum production, worsening of dyspnoea and cough, and reduced health-associated quality of life, all of which affect the patient’s survival [2]. Similar to other diseases that are not characterized by specific aetiology, various factors contribute to the pathogenesis of the disease, including abnormal immune responses, environmental and hormonal factors, and variable gene expression [3]. It has been well-known that under the conditions of AECOPD there is severe airway and systemic inflammation [4]. It has been reported that a variety of markers and cytokines peak during AECOPD

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