<p>Amino Acid-Based Metabolic Indexes Identify Patients With Chronic Obstructive Pulmonary Disease And Further Discriminates Patients In Advanced BODE Stages</p>

Abstract

BackgroundThe BODE index is a multidimensional grading system for predicting the prognoses of patients with chronic obstructive pulmonary disease (COPD). This study investigated whether an amino acids-based metabolic profile developed for heart failure patients (including histidine, ornithine, phenylalanine, and leucine) could identify COPD patients and further discriminates COPD patients in advanced BODE stages.MethodsUltra-performance liquid chromatography was performed on 119 participants, including 75 COPD patients at different BODE stages and 44 normal controls. Albumin, pre-albumin, transferrin, high sensitivity C-reactive protein, and hand grip strength were also measured. Receiver operating characteristic curves and area under curves were used for estimation.ResultsThe BODE points in our patients were 3.29 [95% confidence interval (CI) = 2.74–3.85]. Compared to normal controls, COPD patients had lower leucine but higher ornithine levels. A COPD score, developed based on leucine and ornithine, significantly discriminated COPD from normal controls [odds ratio (OR) = 2.71, 95% CI = 1.83–4.04, p <0.001]. A COPD score of ≥ 3.00 had an OR of 15.58 (95% CI = 5.96–40.73, p <0.001). In COPD patients from BODE 1 to BODE 4, the levels of histidine, ornithine and phenylalanine increased significantly. In multivariable analysis, histidine and phenylalanine were independently able to distinguish BODE stages 3 and 4 from BODE 1 and were adopted to develop a metabolic score. Metabolic scores identified patients at BODE 3 and 4 (OR = 2.74, 95% CI =1.41–5.29, p = 0.003) better than hand grip strength, high sensitive C-reactive protein, albumin, pre-albumin, and transferrin value. A metabolic score of ≥9.53 significantly discriminated BODE 3 and 4 from BODE 1 and 2 (OR = 8.56, 95% CI = 2.77–26.39, p <0.001).ConclusionAmino acid-based COPD score and metabolic score discriminate COPD patients from normal controls, and identify patients in advanced stages of COPD.

Serum Albumin Concentrations in Stable Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

“…After a full-text revision of 46 articles, 20 studies were excluded because they did not meet the inclusion criteria. Thus, twenty-six studies were included in the meta-analysis [ 18 , 19 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ]. The characteristics of the retrieved studies, published between 1994 and 2020, are presented in Table 1 .…”

Machine-Learning Algorithm-Based Prediction of Diagnostic Gene Biomarkers Related to Immune Infiltration in Patients With Chronic Obstructive Pulmonary Disease

“…These findings are consistent with previously discovered factors related to COPD. Earlier experiments have detected altered amino acid levels in patients with serve COPD which may be helpful in the diagnosis and treatment of COPD ( 29 , 30 ). Chronic inflammation is a prominent feature in COPD that results to airway remodeling and lung parenchyma destruction ( 31 ).…”

Development and Validation of a Metabolite Index for Obstructive Sleep Apnea across Race/Ethnicities

“…The downstream effects of phenylalanine have been studied more widely in other chronic conditions, with reports of associations with elevated pro-inflammatory cytokines, suppressed immunity and increased mortality among heart failure patients (42); more rapid telomere shortening consistent with accelerated aging (43). Recent studies reported elevations of phenylalanine associated with adverse COPD outcomes (44), which was postulated to reflect muscle breakdown and respiratory muscle insufficiency (45). Elevated plasma phenylalanine was shown to be a strong predictor for cardiovascular risk (46) and a biomarker, mediator and potentially therapeutic target for pulmonary hypertension (47).…”