Serum Cortisol Levels And Adrenal Gland Size In Patients With Chronic Obstructive Pulmonary Disease

Objective: To determine the clinical significance of serum Cortisol (Cor) levels and adrenal gland size in patients with chronic obstructive pulmonary disease (COPD). Methods: We assigned 80 patients with COPD admitted to our hospital to an observation group, and 80 healthy individuals to a control group. Serum Cor, C-reactive protein (CRP) level, and adrenal gland size were measured. Patients with COPD were divided into several subgroups according to BODE (BMI, Obstruction, Dyspnea, Exercise capacity) indexes and forced expiratory volume in the first second (FEV1), and Cor levels and adrenal gland size were compared between subgroups. The Pearson Correlation was used to analyze correlations of adrenal gland size and Cor levels with partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), FEV1, forced vital capacity (FVC), and FEV1/FVC. After 30 days' follow-up, the patients were allocated into good-prognosis group and poor-prognosis group. The clinical value of Cor levels in predicting prognosis was estimated by the receiver operating characteristic (ROC) curve. Results: Increased serum CRP levels were found in the observation group, while Cor levels and adrenal gland diameter were decreased (P<0.05 for each comparison). In the observation group, an increase in BODE index or decrease in FEV1 led to decreased Cor levels and adrenal gland diameter, as well as increased CRP levels (P<0.05, each comparison). Correlation analysis showed that adrenal gland diameter and Cor levels were positively correlated with PaO2, FEV1, FVC, and FEV1/FVC, but negatively correlated with PaCO2. The ROC curve indicated that Cor levels were valuable in predicting the prognosis (AUC>0.7, P<0.05). Conclusion: Cor levels and adrenal gland size are closely associated with the severity of COPD, and Cor levels are predictive of prognosis.