الفهرس 
Chronic Obstructive PulmonaryOnly 14 pages are availabe for public view
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Abstract
Background: chronic obstructive pulmonary disease (COPD) is a leading and increasing cause of morbidity and mortality worldwide, and is characterized by persistent airflow limitation. Inflammation occupies a central role in the pathogenesis of COPD. In addition to local pulmonary inflammation, systemic inflammation is adding to the complexity of the disease, characterized by increased circulating levels of inflammatory cells, cytokines and acute phase proteins that occur in both stable and during exacerbations. RBP4 is a molecule found in the circulation, thought to be secreted mainly by adipose tissue and the liver, and is a specific transporter for retinol in the circulation. RBP4 has been identified as an adipokine involved in COPD. In this study we assessed the level of serum RBP4 in patients with acute exacerbation of COPD at intensive care unit and compared to stable patients and healthy controls.
Objective: Assessment of serum-retinol binding protein-4 in patients with AECOPD at intensive care unit and the possibility of its use as a predictive biomarker for mortality in AECOPD.
Patients and method: It was conducted on Ninety persons divided into 3 groups:
group 1: Forty patients with AECOPD admitted to ICU.
Group2: thirty patients with stable COPD.
Group3: twenty healthy persons as a control
They were subjected to full history taking, clinical examination, Investigations as liver and kidney functions and serum RBP4 assessment by Enzyme-linked immunosorbent assays.
Samples were collected within first 24 hrs of admission.
Results: There was a significant decrease in serum RBP4 in patients with AECOPD (mean 71.73 ± 33.43) mg/L admitted in ICU than other 2 groups: stable COPD (mean 177.53 ± 93.24) mg/L and healthy controls (mean 231.21± 122.90) mg/L and further decrease in non survivors (mean 48.57 ± 16.26) mg/L than survivors (mean 106.46 ± 18.85) mg/L. (Z=5.301, p= <0.001).RBP4 was positively correlated with body mass index and serum albumin, while negatively correlated with serum creatinine, c reactive protein, total bilirubin and APACHE-II score.
Conclusion: Serum-retinol binding protein-4 can be used as a predictive biomarker for mortality in AECOPD. We recommend that the serum RBP4 should be taken in consideration as a part of the assessment of mortality of AECOPD patients admitted in ICU.