Ramon Boixeda1, Josep Antón Capdevila2, Vanessa Vicente3, Elisabet Palomera4, Jordi Juanola5, Laia Albiach3, Ainhoa Rex3, Jordi Almirall6. 1. Servicio de Medicina Interna, Hospital de Mataró-Consorci Sanitari del Maresme, Mataró, Barcelona, España; Departamento de Medicina. Universidad de Barcelona, Barcelona, España. Electronic address: rboixeda@csdm.cat. 2. Servicio de Medicina Interna, Hospital de Mataró-Consorci Sanitari del Maresme, Mataró, Barcelona, España; Departamento de Medicina, Universidad Autónoma de Barcelona, Barcelona, España. 3. Servicio de Medicina Interna, Hospital de Mataró-Consorci Sanitari del Maresme, Mataró, Barcelona, España. 4. Unidad de Investigación, Consorci Sanitari del Maresme, Mataró, Barcelona, España. 5. Unidad de Neumología, Hospital de Mataró-Consorci Sanitari del Maresme, Mataró, Barcelona, España. 6. Departamento de Medicina, Universidad Autónoma de Barcelona, Barcelona, España; Unidad de Cuidados Intensivos, Hospital de Mataró-Consorci Sanitari del Maresme, Mataró, Barcelona, España.
Abstract
OBJECTIVES: To evaluate the levels of the serum gamma globulin fraction in proteinograms as a biomarker to assess the severity, and to predict the mortality and new exacerbations in patients admitted for an exacerbation of a COPD. PATIENTS AND METHODS: The VIRAE study was carried out on a cohort of patients hospitalized for an exacerbation of probable infectious origin of COPD over a period of 2 years. The levels of the serum gamma globulin fraction were analyzed in the proteinogram of 120 patients. The main clinical indicators of severity were also evaluated. Key features were compared in 2 groups (gamma fraction in the proteinogram greater or less than 6.6g/dl). RESULTS: The levels of the serum gamma fraction in the proteinogram correlated with the FEV1 (P=.009), the CRP (P=.04), and the number of readmissions after 6 months of hospitalization (P=.04). We observed a good association with the GOLD scale, the BODE index and the mMRC dyspnea scale; and also with treatment with oral corticoids and home oxygen therapy. We did not find it to be a good predictor of mortality, despite observing increased mortality rates one year after hospital admission in patients with low levels of the factor. CONCLUSIONS: The levels of the gamma globulin fraction in proteinograms has a good correlation with the FEV1. In addition, they are associated with a greater severity of patients with COPD. This simple biomarker may be useful in identifying high-risk patients.
OBJECTIVES: To evaluate the levels of the serum gamma globulin fraction in proteinograms as a biomarker to assess the severity, and to predict the mortality and new exacerbations in patients admitted for an exacerbation of a COPD. PATIENTS AND METHODS: The VIRAE study was carried out on a cohort of patients hospitalized for an exacerbation of probable infectious origin of COPD over a period of 2 years. The levels of the serum gamma globulin fraction were analyzed in the proteinogram of 120 patients. The main clinical indicators of severity were also evaluated. Key features were compared in 2 groups (gamma fraction in the proteinogram greater or less than 6.6g/dl). RESULTS: The levels of the serum gamma fraction in the proteinogram correlated with the FEV1 (P=.009), the CRP (P=.04), and the number of readmissions after 6 months of hospitalization (P=.04). We observed a good association with the GOLD scale, the BODE index and the mMRC dyspnea scale; and also with treatment with oral corticoids and home oxygen therapy. We did not find it to be a good predictor of mortality, despite observing increased mortality rates one year after hospital admission in patients with low levels of the factor. CONCLUSIONS: The levels of the gamma globulin fraction in proteinograms has a good correlation with the FEV1. In addition, they are associated with a greater severity of patients with COPD. This simple biomarker may be useful in identifying high-risk patients.