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Correlation between serum bilirubin levels and the severity as well as the prognosis of idiopathic pulmonary fibrosis.
Chronic Respiratory Disease ( IF 4.1 ) Pub Date : 2020-09-10 , DOI: 10.1177/1479973120957676
Shenyun Shi 1 , Yin Liu 1 , Xiaohua Qiu 1 , Min Cao 1 , Yonglong Xiao 1 , Xin Yan 1
Affiliation  

Bilirubin exerts antioxidant activity that has been associated with respiratory diseases. However, the relationship between serum bilirubin levels and idiopathic pulmonary fibrosis (IPF) is not clear. Therefore, in this study, we evaluated the relationship between serum bilirubin levels and the severity as well as the prognosis of IPF. One hundred and forty-six patients with IPF and 69 healthy individuals as the control group were enrolled as a derivation cohort. Routine blood examination and pulmonary function tests were performed and serum bilirubin levels were measured. To validate the value of serum bilirubin levels to predict the survival of patients with IPF, 40 additional IPF patients were included as a validation cohort. IPF patients were followed-up. Patients with IPF had significantly lower levels of serum total bilirubin (TBIL) and direct bilirubin (DBIL) than those in the control group (P < 0.05). Patients with acute exacerbation of IPF (AE-IPF) had significantly lower levels of serum TBIL and IBIL than those in patients with stable IPF (P < 0.05). The area under the receiver operating characteristic curve (AUROC) of serum TBIL levels for the prediction of the incidence of AE-IPF was 0.72 (95% CI: 0.56–0.87, P = 0.0057). The best cutoff value of serum TBIL level to predict the survival of patients with IPF was 8.8 μmol/l (AUC = 0.75, 95% CI: 0.64–0.87, P = 0.022). The log-rank test showed a significant difference in survival between the two groups (TBIL ≤8.8 μmol/l and TBIL >8.8 μmol/l) in derivation and validation cohort. Cox multiple regression analysis indicated that serum TBIL levels were an independent prognostic factor for IPF prognosis (HR = 0.582, P = 0.026). Serum TBIL levels might be useful for reflecting the severity and predicting the survival of patients with IPF.



中文翻译:

血清胆红素水平与特发性肺纤维化严重程度及预后的相关性。

胆红素发挥与呼吸系统疾病相关的抗氧化活性。然而,血清胆红素水平与特发性肺纤维化(IPF)之间的关系尚不清楚。因此,在本研究中,我们评估了血清胆红素水平与 IPF 的严重程度和预后之间的关系。146 名 IPF 患者和 69 名健康个体作为对照组被纳入衍生队列。进行常规血液检查和肺功能检查并测量血清胆红素水平。为了验证血清胆红素水平预测 IPF 患者生存的价值,另外 40 名 IPF 患者被纳入验证队列。对 IPF 患者进行了随访。P < 0.05)。IPF急性加重期(AE-IPF)患者血清TBIL和IBIL水平显着低于IPF稳定期患者(P < 0.05)。用于预测 AE-IPF 发生率的血清 TBIL 水平的受试者工作特征曲线下面积 (AUROC) 为 0.72 (95% CI: 0.56–0.87, P = 0.0057)。预测 IPF 患者生存期的血清 TBIL 水平的最佳临界值为 8.8 μmol/l(AUC = 0.75,95% CI:0.64–0.87,P =0.022)。对数秩检验显示,在推导和验证队列中,两组(TBIL ≤ 8.8 μmol/l 和 TBIL > 8.8 μmol/l)的生存率存在显着差异。Cox多元回归分析表明血清TBIL水平是IPF预后的独立预后因素(HR=0.582,P =0.026)。血清 TBIL 水平可能有助于反映 IPF 患者的严重程度和预测其生存率。

更新日期:2020-09-10
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