Serum β2-Microglobulin is Associated with Mortality in Hospitalized Patients with Exacerbated Chronic Obstructive Pulmonary Disease
Received 23 January 2020
Accepted for publication 15 March 2020
Published 7 April 2020 Volume 2020:15 Pages 723—732
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Chunxue Bai
Wenping Mao,1,2 Jing Wang,1,2 Liming Zhang,1,2 Ying Wang,1,2 Wenjun Wang,1,2 Na Zeng,3 Jun Zhang,1,2 Qian li,1,2 Fengwei Jiao,1,2 Jie Li,1,2 Na Cui,1,2 Song Mi,1,2 Yi Xue,1,2 Zhaomei Wang,1,2 Sun Ying,4 Kewu Huang1,2
1Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, People’s Republic of China; 2Beijing Institute of Respiratory Medicine, Beijing 100020, People’s Republic of China; 3Clinical Epidemiology and EBM Unit, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, People’s Republic of China; 4Department of Immunology, School of Basic Medical Sciences, Capital Medical University, Beijing 100069, People’s Republic of China
Correspondence: Kewu Huang
Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing 100020, People’s Republic of China
Tel + 86-10-85231167
Purpose: We hypothesized that increased level of serum β 2-microglobulin (β 2M) is an independent factor associated with higher mortality in hospitalized patients with exacerbated chronic obstructive pulmonary disease (COPD).
Patients and Methods: We retrospectively analyzed 488 hospitalized patients with exacerbated COPD as the first diagnosis at Beijing Chao-Yang hospital, P. R. China between December 31st, 2012 and December 28th, 2017. Concentrations of serum β 2M and other clinical indexes were measured or collected on admission, and all patients were followed up to 90 days. The relationship between β 2M and 30- and 90-day all-cause mortality was explored by Cox regression analysis adjusted for age, C-reactive protein values, N-terminal pro-brain natriuretic peptide/100, respiratory failure [RF, defined as partial arterial oxygen pressure (PaO2) < 60 mmHg on room air or PaO2 over the fraction of inspired oxygen (PaO2/FiO2) < 300], eosinopenia, consolidation, and acidaemia.
Results: Median concentrations of β 2M were significantly higher in non-survivals compared to survivals within 30 days (4.11 mg/L (IQR 3.10– 6.60) vs 2.79mg/L (IQR 2.13– 3.76), P < 0.001) and 90 days (3.79 mg/L (IQR 2.61– 6.69) vs 2.79 mg/L (IQR 2.13– 3.73), P < 0.001). Serum levels of β 2M were correlated with 30-day and 90-day mortality in overall exacerbated COPD patients, with hazard ratios (HRs) of 1.09 (95% CI 1.04– 1.14, P = 0.001) and 1.09 (95% CI 1.05– 1.14, P < 0.001). In exacerbated COPD patients without RF and with RF, the HRs were 1.06 (95% CI 0.995– 1.137, P = 0.069) and 1.14 (95% CI 1.02– 1.27, P = 0.021) for 30-day mortality, 1.09 (95% CI 1.02– 1.15, P = 0.010) and 1.14 (95% CI 1.03– 1.26, P = 0.014) for 90-day mortality, respectively.
Conclusion: Our data showed that concentrations of serum β 2M were associated with an increased risk of mortality, suggesting that β 2M might be a valuable predictor of poor prognosis for hospitalized patients with exacerbated COPD.
Keywords: β 2-microglobulin, COPD, exacerbation, predictor, prognosis
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