Relationship between serum cortisol level and disease severity in patients with AECOPD

ObjectiveTo analyze the relationship between serum level of cortisol(COR) and disease severity of acute exacerbations of chronic obstructive pulmonary disease(AECOPD).

MethodsTwo hundred and eight patients with COPD were divided into the stable COPD group(100 cases) and AECOPD group(108 cases) according to the condition of COPD.The AECOPD group was subdivided into the mild group(n=34), moderate group(n=35) and severe group(n=39), and 100 healthy people during the same period were set as the control group.The levels of adrenocorticotropic hormone(ACTH) and COR among three groups were compared.The diagnostic value of ACTH and COR levels in AECOPD, and correlation between ACTH and COR levels and severity of AECOPD were analyzed.

ResultsThe serum levels of ACTH and COR in the AECOPD group, stable COPD group and control group gradually decreased, and the differences of which among three groups were statistically significant(P < 0.01).The value of ACTH combined with COR in the parallel diagnosis of AECOPD(AUC=0.897) was better than that of the singe ACTH or COR(AUC=0.715 or 0.823) and tandem diagnosis of the two(AUC=0.837).The serum levels of ACTH and COR in the mild, moderate and severe AECOPD group were gradually up-regulated, and the differences of which among three groups were statistically significant(P < 0.01).The levels of ACTH and COR were positively correlated with the severity of the disease(r=0.532, 0.467, P < 0.05).

ConclusionsThe serum levels of COR and ACTH in patients with AECOPD are abnormally high, and the combination of the two is of better value in the diagnosis of AECOPD, and it is positively correlated with the severity of patient's disease.