The diagnostic value of homocysteine for the occurrence and acute progression of chronic obstructive pulmonary disease
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RESEARCH ARTICLE
Open Access
The diagnostic value of homocysteine for the occurrence and acute progression of chronic obstructive pulmonary disease Bing Wei1†, Tian Tian1†, Yugeng Liu1* and Chunsheng Li2*
Abstract Background: This study aimed to evaluate whether the Homocysteine (Hcy) level was elevated in chronic obstructive pulmonary disease (COPD) patients and its correlation with the occurrence and acute progression of COPD. Methods: From November 2014 to November 2015, COPD patients were enrolled from Beijing Chao-yang Hospital, and the the biological and clinical data were collected. These patients were tested in the non-acute exacerbation period and the acute exacerbation period, so they were defined as AECOPD group and Non-AECOPD group. Besides, 50 healthy subjects were recruited and defined as control group. Total plasma Hcy levels (antibodies-online, USA) were determined by enzyme-linked immunosorbent assay. Correlation analysis was used to analyze the correlation between serum Hcy level and ventilatory function. Using ROC curve, the diagnostic value of Hcy for the occurrence and acute progression of COPD was explored. Results: In this study, we found that Hcy levels in the Non-AECOPD group or the AECOPD group were significantly higher than those in the control group (P < 0.001). Meanwhile, compared with the Non-AECOPD group, the Hcy level in the AECOPD group was significantly higher (P < 0.001). In addition, according to the classification of GOLD grade, there was significant difference in the Hcy level among different GOLD grade groups (P < 0.001). The correlation analysis showed that in the AECOPD group and the Non-AECOPD group, Hcy levels presented a negative correlation with FEV1(r < 0). Meanwhile, FEV1% was also negatively correlated with Hcy level (r < 0). ROC curve analysis showed that when the cutoff value was set to 10.8 μg/ml, the specificity, sensitivity and AUC were the best, which were 0.980, 0.800, and 0.945, respectively. Besides, our results showed that when the cutoff value was set to 14.0 μg / ml, the specificity, sensitivity and AUC were the best, which were 0.846, 0.680, and 0.802, respectively. In addition, compared with the prediction of acute progression of COPD, when Hcy level predicted the occurrence of COPD, its specificity (0.980 vs. 0.846, P < 0.001) and sensitivity (0.800 vs. 0.680, P < 0.001) were significantly higher. Conclusion: Hcy level is positively correlated with the severity of COPD patients, which has predictive value for the occurrence of COPD and acute progression. Keywords: COPD, Homocysteine, Acute progression, Occurrence * Correspondence: [email protected]; [email protected] † Bing Wei and Tian Tian contributed equally to this work and are co-first authors of this article. 1 Department of Emergency Medicine, Beijing Chao-Yang Hospital Jingxi Branch, Capital Medical University, No.5 Jingyuan Road, Shijingshan, Beijing 100043, China 2 Department of Emergency Medicine, Beijing Chao-Yang Hospital, Capital Medical University, No.8 Gongti South Road, Chaoyang Distr
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