THE SIGNIFICANCE OF CIRCULATING SURFACTANT PROTEIN D AND DYSLIPIDEMIA IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE,...

As it is widely known, cardiovascular diseases represent one of the leading causes of mortality. In the coexistence of chronic obstructive pulmonary disease (COPD), the mortality rate is increasing as well. The research conducted reviews the effect of surfactant protein D on the coronary heart disease and chronic obstructive pulmonary disease.The cohort of 90 patients was included in the study. The patients were divided into five groups: group I (the patients with coronary heart disease - CHD); group II (the patients with dyslipidemia); group III (the patients with COPD); group IV (the patients suffering from the combination of CHD and COPD); group V (control group). The laboratory (dyslipidemia - through enzymatic method) as well as the instrumental methods (echocardiography, spirometric examination) were applied in the study.In consequence of the statistical processing of materials within the study, the relatively high level of surfactant protein D (SP-D) values determined in groups was revealed in group II (the patients with dyslipidemia), SP-D-25.9±19.6 ng/ml. Similar data were identified in practically healthy individuals - control group (group V). Performing the comparative analysis of data, the statistically high value of anti-atherogenic HDLC (52.5±10.5 mg/dl) was observed in group II (the patients with dyslipidemia) compared to group IV (p=0.002). It is worth noting that in the patients of group IV (COPD+CHD) the quantitative HDLC was statistically lower (43.6±6.5mg/dL) in comparison with the data of all other groups: (group I - HDLC-51,6±6,8; group II -52.5±10.5; group III-50.7±9.5; group V - 50.3±8.4) p1-4<0.001; p2-4=0.002; p3-4=0.005; p4-5=0.02. Considering the above-mentioned data, we can draw the conclusion that along with the elevated level of circulated SP-D, the low HDLC value can be utilized as a marker of the severe course of disease in relation to COPD as well as CHD.The high level of SP-D, which does not have the significant atherogenic effect (due to the presence of high HDLC), was detected in individuals with isolated dyslipidemia. The study has established that in the presence of CHD, in line with the increase in atherogenic lipoproteins and relatively low HDLC value, there is detected the high level of SP-D, which is correlated with lung function indices (FEV 1 and FVC). And in case of the coexistence of COPD and CHD where dyslipidemia, the elevated level of SP-D and corresponding changes in pulmonary function tests are manifested, there were identified the high risks of severe course of disease, the development of heart failure and mortality.