PDF(Pubmed)
Abstract：
Serum total bilirubin has been reported to have antioxidant properties against chronic respiratory diseases. The objective of our study is to evaluate the association of total bilirubin (TB) with annual lung function decline in COPD patients with different GOLD stages.
This study used pooled data from two observational and prospective cohorts of 612 COPD patients whose TB levels were measured at baseline. The associations between TB and postbronchodilator FEV1, FEV1pred, FVC, FVCpred, FEV1/FVC, and the rate of their decline were all determined using linear regression models in the total population and strata of GOLD stages.
Serum TB was positively related to FEV1 and FVC in the total group (β 0.02, 95% CI 0.001~0.02, P = 0.025 and β 0.02, 95% CI 0.002~0.03, P = 0.022, respectively). Additionally, TB was inversely associated with the annual decline in FEV1 and FEV1pred (β 4.91, 95% CI 1.68~8.14, P = 0.025 and β 0.21, 95% CI 0.06~0.36, P = 0.022, respectively) when adjusted for multivariables. After stratification, the significant associations merely persisted in COPD patients with GOLD 2 and GOLD 3-4.
Increased TB level was related to less annual decline in FEV1 as well as FEV1pred in moderate-to-severe COPD but not mild COPD, which indicated the different status of TB in different COPD severity and the possible role as potential biomarker merely in moderate-to-severe COPD. Future researches to determine whether TB could be served as biomarker for COPD and the mechanisms should be focused on some target patients with a certain disease severity.
This study used pooled data from two observational and prospective cohorts of 612 COPD patients whose TB levels were measured at baseline. The associations between TB and postbronchodilator FEV1, FEV1pred, FVC, FVCpred, FEV1/FVC, and the rate of their decline were all determined using linear regression models in the total population and strata of GOLD stages.
Serum TB was positively related to FEV1 and FVC in the total group (β 0.02, 95% CI 0.001~0.02, P = 0.025 and β 0.02, 95% CI 0.002~0.03, P = 0.022, respectively). Additionally, TB was inversely associated with the annual decline in FEV1 and FEV1pred (β 4.91, 95% CI 1.68~8.14, P = 0.025 and β 0.21, 95% CI 0.06~0.36, P = 0.022, respectively) when adjusted for multivariables. After stratification, the significant associations merely persisted in COPD patients with GOLD 2 and GOLD 3-4.
Increased TB level was related to less annual decline in FEV1 as well as FEV1pred in moderate-to-severe COPD but not mild COPD, which indicated the different status of TB in different COPD severity and the possible role as potential biomarker merely in moderate-to-severe COPD. Future researches to determine whether TB could be served as biomarker for COPD and the mechanisms should be focused on some target patients with a certain disease severity.
摘要：
据报道，血清总胆红素具有抗慢性呼吸道疾病的抗氧化特性。我们研究的目的是评估总胆红素（TB）与不同GOLD分期的COPD患者年肺功能下降的关系。
本研究使用了来自两个观察性和前瞻性队列的汇总数据，这些队列包括612名COPD患者，这些患者在基线时测量了TB水平。TB与支气管扩张剂后FEV1，FEV1pred，FVC,FVCpred,FEV1/FVC,并且它们的下降率都是使用线性回归模型在GOLD阶段的总人口和阶层中确定的。
全组血清TB与FEV1、FVC呈正相关(β0.02,95%CI0.001~0.02,P=0.025和β0.02,95%CI0.002~0.03,P=0.022)。此外,多变量校正后，TB与FEV1和FEV1pred的年下降呈负相关（分别为β4.91，95％CI1.68〜8.14，P=0.025和β0.21，95％CI0.06〜0.36，P=0.022）。分层后,仅在患有GOLD2和GOLD3-4的COPD患者中存在显著关联.
在中度至重度COPD但轻度COPD中，TB水平升高与FEV1和FEV1pred的年度下降较少相关，这表明在不同的COPD严重程度中TB的不同状态以及仅在中重度COPD中作为潜在生物标志物的可能作用。未来确定TB是否可以作为COPD的生物标志物的研究，其机制应集中在一些具有一定疾病严重程度的目标患者身上。
本研究使用了来自两个观察性和前瞻性队列的汇总数据，这些队列包括612名COPD患者，这些患者在基线时测量了TB水平。TB与支气管扩张剂后FEV1，FEV1pred，FVC,FVCpred,FEV1/FVC,并且它们的下降率都是使用线性回归模型在GOLD阶段的总人口和阶层中确定的。
全组血清TB与FEV1、FVC呈正相关(β0.02,95%CI0.001~0.02,P=0.025和β0.02,95%CI0.002~0.03,P=0.022)。此外,多变量校正后，TB与FEV1和FEV1pred的年下降呈负相关（分别为β4.91，95％CI1.68〜8.14，P=0.025和β0.21，95％CI0.06〜0.36，P=0.022）。分层后,仅在患有GOLD2和GOLD3-4的COPD患者中存在显著关联.
在中度至重度COPD但轻度COPD中，TB水平升高与FEV1和FEV1pred的年度下降较少相关，这表明在不同的COPD严重程度中TB的不同状态以及仅在中重度COPD中作为潜在生物标志物的可能作用。未来确定TB是否可以作为COPD的生物标志物的研究，其机制应集中在一些具有一定疾病严重程度的目标患者身上。
