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Serum β2-Microglobulin is Associated with Mortality in Hospitalized Patients with Exacerbated Chronic Obstructive
Wenping Mao1,2, Jing Wang1,2, Liming Zhang1,2
1Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, People's Republic of China.
Purpose:
We hypothesized that increased level of serum β2-microglobulin (β2M) is an independent factor associated with higher mortality in hospitalized patients with exacerbated chronic obstructive pulmonary disease (COPD).
Patients And Methods:
We retrospectively analyzed 488 hospitalized patients with exacerbated COPD as the first diagnosis at Beijing Chao-Yang hospital, P. R. China between December 31st, 2012 and December 28th, 2017. Concentrations of serum β2M and other clinical indexes were measured or collected on admission, and all patients were followed up to 90 days. The relationship between β2M and 30- and 90-day all-cause mortality was explored by Cox regression analysis adjusted for age, C-reactive protein values, N-terminal pro-brain natriuretic peptide/100, respiratory failure [RF, defined as partial arterial oxygen pressure (PaO2) <60 mmHg on room air or PaO2 over the fraction of inspired oxygen (PaO2/FiO2) < 300], eosinopenia, consolidation, and acidaemia.
Results:
Median concentrations of β2M were significantly higher in non-survivals compared to survivals within 30 days (4.11 mg/L (IQR 3.10-6.60) vs 2.79mg/L (IQR 2.13-3.76), P < 0.001) and 90 days (3.79 mg/L (IQR 2.61-6.69) vs 2.79 mg/L (IQR 2.13-3.73), P < 0.001). Serum levels of β2M were correlated with 30-day and 90-day mortality in overall exacerbated COPD patients, with hazard ratios (HRs) of 1.09 (95% CI 1.04-1.14, P = 0.001) and 1.09 (95% CI 1.05-1.14, P < 0.001). In exacerbated COPD patients without RF and with RF, the HRs were 1.06 (95% CI 0.995-1.137, P = 0.069) and 1.14 (95% CI 1.02-1.27, P = 0.021) for 30-day mortality, 1.09 (95% CI 1.02-1.15, P = 0.010) and 1.14 (95% CI 1.03-1.26, P = 0.014) for 90-day mortality, respectively.
Conclusion:
Our data showed that concentrations of serum β2M were associated with an increased risk of mortality, suggesting that β2M might be a valuable predictor of poor prognosis for hospitalized patients with exacerbated COPD.
Insights
Elevated serum beta-2 microglobulin (β2M) levels predict higher mortality in hospitalized patients with exacerbated chronic obstructive pulmonary disease (COPD). This finding suggests β2M is a valuable prognostic marker for COPD exacerbations.
Area of Science:
- Pulmonary Medicine
- Biomarkers
- Clinical Research
Background:
- Chronic obstructive pulmonary disease (COPD) exacerbations are a major cause of hospitalization and mortality.
- Identifying reliable prognostic markers is crucial for managing patients with exacerbated COPD.
Purpose of the Study:
- To investigate the association between serum beta-2 microglobulin (β2M) levels and mortality in hospitalized patients experiencing COPD exacerbations.
- To determine if β2M is an independent predictor of short-term mortality in this patient group.
Main Methods:
- Retrospective analysis of 488 hospitalized patients with exacerbated COPD.
- Serum β2M concentrations measured on admission.
- Follow-up for 90-day all-cause mortality.
- Cox regression analysis adjusted for clinical factors including respiratory failure.
Main Results:
- Median serum β2M levels were significantly higher in non-survivors compared to survivors at both 30 and 90 days (P < 0.001).
- Serum β2M levels were independently associated with increased 30-day (HR 1.09) and 90-day (HR 1.09) mortality.
- The association remained significant, particularly in patients with respiratory failure.
Conclusions:
- Serum β2M is a valuable predictor of mortality in hospitalized patients with exacerbated COPD.
- Elevated β2M levels indicate a poorer prognosis and increased risk of death.
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