SIGNIFICANCE OF CHANGES IN SERUM SICAM-1 AND TBIL IN PATIENTS WITH ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE COMBINED WITH TYPE 2 DIABETES

Juan Zeng^{1,2 #}, Gongpu Xu^{3, #}, Qinghua Zeng^{1, 2,} Xiang Wang^1,2, Lin Liu^4,5*

¹Department of General Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, China - ²Department of General Medicine, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu 610072, China - ³Intensive Care Unit, Chengdu Shuangliu first people's Hospital. West china (Airport) Hospital Sichuan Univrersity, Chengdu 610200, China -⁴Department of Medical Administration, Sichuan Provincial People's Hospital,University of Electronic Science and Technology of China,Chengdu 610072, China - ⁵Department of Medical Administration, Chinese  Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu 610072, China

Introduction: To explore the significance of changes in serum soluble intercellular adhesion molecule-1 (sICAM-1) and total bilirubin (TBIL) in patients with acute exacerbation of COPD combined with type 2 diabetes.

Materials and method: Ninety-one patients with acute exacerbation of COPD combined with type 2 diabetes were included in the case group. Ninety-one patients with acute exacerbation of COPD alone were selected as a control group. Serum sICAM-1, TBIL, and malondialdehyde (MDA) and superoxide dismutase (SOD) were compared. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum sICAM-1 and TBIL for the development of type 2 diabetes in patients with acute exacerbations of COPD.

Results: Serum sICAM-1 and MDA in case group were higher than those in control group (both p<0.001); but serum TBIL and SOD in case group were the opposite (both p<0.001). In case group, serum sICAM-1 level was positively correlated with serum MDA and negatively correlated with serum SOD; and serum TBIL level was negatively correlated with serum MDA and positively correlated with serum SOD. ROC curve analysis showed that the area under ROC curve for serum sICAM-1 and TBIL level to predict acute exacerbation of COPD combined with type 2 diabetes was 0.783 (95%CI: 0.718-0.849) and 0.600 (95%CI: 0.515-0.685), respectively, the area under ROC curve of the former was larger than that of the latter.

Conclusions: Serum sICAM-1 and MDA levels increase and serum TBIL and SOD levels decrease in patients with acute exacerbation of COPD combined with type 2 diabetes, and the increased serum sICAM-1 and decreased TBIL levels may be related to oxidative stress in these patients. Both serum sICAM-1 and TBIL are useful for the diagnosis of COPD combined with type 2 diabetes, but the former has higher diagnostic efficacy than the latter.