Expression and clinical significance of serum inflammatory factors in patients with preserved ratio impaired spirometry

LU Tong; CHEN Hao; CHEN Bi

doi:10.3969/j.issn.1002-3429.2025.22.006

Abstract：Objective To analyze the expression of serum inflammatory factors in patients with preserved ratio impaired spirometry(PRISm)and its predictive efficacy for disease progression.Methods According to the 1:1 matching principle,202 patients with PRISm(PRISm group)and 202 volunteers with normal pulmonary function during physical examination(control group)from January 2021 to December 2023 were selected.The serum inflammatory factors[interleukin(IL)-10,transforming growth factor-β1(TGF-β1),IL-17A,IL-21,IL-22,IL-6,tumor necrosis factor-α(TNF-α)]of the two groups were compared.Patients with PRISm were stratified into the progression group and the non-progression group based on presence of chronic obstructive pulmonary disease during follow-up.The clinical data and serum inflammatory factors were compared between the progression group and the non-progression group.Multivariate logistic regression was used to analyze the influencing factors of disease progression in patients with PRISm.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum inflammatory factors for disease progression,and the precision-recall(PR)curve was used to evaluate the value of combined prediction.Results The serum IL-10 level in the PRISm group was lower than that in the control group,while the levels of serum TGF-β1,IL-17A,IL-21,IL-22,IL-6 and TNF-α were higher than those in the control group(P＜0.05).There were significant differences in age,body mass index(BMI),smoking history and emphysema between the non-progression group and the progression group(P＜0.05).The serum IL-10 level in the progression group was lower than that in the non-progression group,while the levels of serum TGF-β1,IL-17A,IL-21 and IL-22 were higher than those in the non-progression group(P＜0.05).Before and after adjusting for variables such as age,BMI,and smoking history,the levels of serum TGF-β1,IL-17A,IL-21,and IL-22 were all independent influencing factors for disease progression in patients with PRISm(P＜0.05).The area under the ROC curve(AUC)for the combined prediction of disease progression in PRISm patients by serum levels of IL-10,TGF-β1,IL-17A,IL-21,and IL-22 was larger than that by the combined prediction of age,BMI,smoking history,and emphysema.The PR curve showed that the AUC for the combined prediction of serum inflammatory factors was 0.834.Conclusion The levels of serum IL-10,TGF-β1,IL-17A,IL-21 and IL-22 are closely related to the disease progression of patients with PRISm.The combination of the above serum inflammatory factors has a good efficacy in predicting the disease progression of patients.