Analysis on correlation of serum amyloid A with pulmonary diffusion function and exercise limitation in eld-erly patients with COPD
OU Yang
ZHONG Canye
ZHANG Shutang
WANG Wei
Abstract：Objective To analyze the correlation of serum amyloid A(SAA)with pulmonary diffusion function and exercise limitation in elderly patients with chronic obstructive pulmonary disease(COPD).Methods A total of 188 elderly patients with stable COPD who were admitted to Chongqing University Fuling Hospital from January 2020 to July 2021 were recruited.All the patients underwent pulmonary function test(PFT)and cardiopulmonary exercise tes-ting(CPET)evaluations.The patients with transfer factor for carbon monoxide(TLCO)of lung＜lower limit of normal lung(LLN)were included in the abnormal diffusion function group(102 cases),and the patients with TL CO≥LLN were included in the normal diffusion function group(86 cases).SA A levels were determined using enzyme-linked immu-nosorbent assay(ELISA).Pearson correlation analysis was used to investigate the correlation between SAA level and peak oxygen uptake(VO2peak).Multivariate logistic regression was used to analyze the influencing factors of pulmonary diffusion function in the elderly patients with COPD.Multivariate linear regression model was used to analyze the corre-lation of SAA level with Z-score of forced expiratory volume in the first second(FEV1Zscore)and FEV1 as a percentage of predicted value(ppFEV1)in the elderly COPD patients.Receiver operating characteristic(ROC)curve was used to ana-lyze the predictive efficacy of SAA level on pulmonary diffusion dysfunction in the elderly patients with COPD.Results The results of multivariate logistic regression analysis showed that lower ppFEV1,Z-score of forced vital capacity(FVCZ-score),(FEV1/FVC)Z-score were independent risk factors for promoting pulmonary diffusion dysfunction in the elderly COPD patients(P＜0.05),and higher FVC as a percentage of predicted value(ppFVC),FEV1/FVC,and Z-score of alve-olar ventilation(VAz-score)were independent protecting factors for inhibiting pulmonary diffusion dysfunction in the eld-erly COPD patients(P＜0.05).The SAA level in the abnormal diffusion function group was higher than that in the normal diffusion function group[(135.09±58.05)ng/mL vs(78.10±32.81)ng/mL,t=8.079,P＜0.001].The results of ROC curve analysis showed that SAA level had application value in predicting pulmonary diffusion dysfunction in the elderly COPD patients[AUC(95％CI)=0.797(0.735-0.860),P＜0.001],and the optimal cut-off value was 85.07 ng/mL.The corresponding sensitivity and specificity were 77.50％and 69.80％,respectively.The results of multivariate linear regression analysis showed that for each unit decrease in FEV1z-score and ppFEV1,the SAA level of the patients in the abnormal diffusion function group was increased by 0.009(95％CI:-0.013--0.005)ng/mL and 0.149(95％CI:-0.210--0.088)ng/mL.The results of Pearson correlation analysis showed that SAA level was nega-tively correlated with VO2peak in the elderly patients with COPD(r=-0.512,P＜0.001).Conclusion In elderly COPD patients,SAA level is associated with FEV1Z-score,and detecting the SAA level can help to identify the elderly COPD patients with pulmonary diffusion dysfunction.In addition,there is a negative correlation between SAA level and VO2peak,suggesting that the mechanism leading to FEV1 reduction may help to explain the exercise limitation in the elderly COPD patients with pulmonary diffusion dysfunction.
Keywords：Serum amyloid AChronic obstructive pulmonary disease(COPD)Emphysema phenotypeExercise tolerance
Publication Date：2024-01-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 79-86 )