Evaluation of serum iNOS and eNOS levels in predicting frequent acute exacerbations in stable chronic obstruc-tive pulmonary disease patients
GUO Zhi-qiang
LIU Yun-feng
GAO Xiao-ling
LI Run-jie
ZHAO Li-chun
Abstract：Objective To investigate the value of serum inducible nitric oxide synthase(iNOS)and endothelial nitric oxide synthase(eNOS)levels in assessing frequent acute exacerbations in stable chronic obstructive pulmonary dis-ease(COPD)patients.Methods A total of stable COPD patients hospitalized from January 2020 to June 2022 were se-lected for the study.Patients were divided into two groups based on the frequency of acute exacerbations occurring within one year after discharge:≥2 exacerbations(frequent exacerbation group)and≤1 exacerbation(non-frequent exacer-bation group).The serum levels of iNOS and eNOS,along with clinical data,were compared between the two groups.Lo-gistic regression was used to analyze the risk factors for disease exacerbation,and receiver operating characteristic(ROC)curves were used to evaluate the predictive value of the related indicators.Results The serum iNOS and eNOS levels,as well as the COPD Assessment Test(CAT)scores,were significantly higher in the frequent exacerbation group compared to the non-frequent exacerbation group[(4.12±1.01)ng/mL vs.(3.07±0.65)ng/mL,(8.19±0.99)ng/mL vs.(6.24±1.13)ng/mL,17.33±5.19 vs.12.64±4.58,t=6.139,8.674,4.585,P＜0.05],while albumin levels were lower in the frequent exacerbation group[(32.73±4.53)g/L vs.(34.29±4.06)g/L,t=2.732,P＜0.05].High serum levels of iNOS,eNOS,and high CAT scores were identified as risk factors for frequent acute exacerbations in stable COPD patients(OR=4.831,3.638,1.188,P＜0.05).The serum iNOS,eNOS levels,and CAT scores,both individually and in combination,all showed predictive value for frequent acute exacerbations.The combined prediction model showed an area under the curve of 0.939(95％ CI:0.890-0.989),with a sensitivity of 86.21％ and specificity of 88.89％.Conclusion Elevated serum iNOS and eNOS levels are associated with frequent acute exacerbations in sta-ble COPD patients.Both iNOS and eNOS,in combination with CAT scores,show significant predictive value for exacerba-tion risk.
Keywords：chronic obstructive pulmonary diseasefrequent acute exacerbationsinducible nitric oxide syn-thaseendothelial nitric oxide synthaseinfluencing factorsprediction
Publication Date：2025-04-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 587-591 )