Predictive value of serum NOX4 combined with Nrf2 on acute exacerbation of stable COPD patients
Objective To investigate the predictive value of serum NADPH oxidase 4(NOX4)combined with nuclear factor erythroid 2 related factor 2(Nrf2)on acute exacerbation of stable chronic obstructive pulmonary disease(COPD)patients.Methods One hundred and thirty-eight stable COPD patients who were hospitalized in the First Affiliated Hospital of Hebei North University from August 2019 to December 2021 and observed to have acute exacerbations while being followed up within one year after discharge were selected as the research subjects.According to the times of acute exacerbations during one year after discharge,they were divided into frequent group with ≥ 2 exacerbations(n=52)and non-frequent group with≤1 exacerbation(n=86).The differences of baseline clinical data and serum NOX4 and Nrf2 levels between the two groups were compared,multivariate logistic regression was used to analyze the influencing factors of frequent acute exacerbation within one year,and ROC curve was used to analyze the predictive value of NOX4 and Nrf2 on frequent acute exacerbation of stable COPD patients within one year.Results The ratio of diabetes history,and serum NOX4 level in the frequent group were higher than those in the non-frequent group,while serum ALB and Nrf2 levels were lower than those in the non-frequent group(all P<0.05).Multivariate logistic regression analysis showed that combination of diabetes and increased NOX4 level were risk factors for frequent acute exacerbation of stable COPD patients within one year,while increased Nrf2 level was a protective factor(all P<0.05).ROC analysis showed that serum NOX4 and Nrf2 and in combination had predictive value for frequent acute exacerbation of stable COPD patients within one year,and the sensitivity and specificity of their combined prediction were 0.814 and 0.885,respectively.Conclusion Serum NOX4 and Nrf2 are expected to be potential markers for frequent acute exacerbation of COPD patients within 1 year.