Data Availability StatementAll data generated during and/or analyzed during the current research can be found from the corresponding writer upon reasonable demand. rs198388 loci elevated successively, and the serum Apelin proteins levels reduced successively (all at the rs198389, rs6668352, and rs198388 loci are linked to the occurrence of COPD and COPD with PH, and the occurrence may be related to the abnormal expression level of BNP, Fbg, and Apelin protein in the serum. test was used to compare the skewed distributions of the continuous variables. A non-parametric statistical analysis between the two groups was performed using a (%)]68 (54.4%)112 (54.6%)81 (60.4%)0.291Course (years)C16.1 5.8 (2, 27)16.4 5.5 (5, 27)0.635BMI (kg/m2)22.8 2.4 (18.9, 26.1)22.5 2.4 (16.7, 27.5)22.4 2.5 (17.8, 27.3)0.490Smoking (pack/12 months)31.6 3.7 (24, 38)32.4 4.1 (23, 39)32.0 4.1 (23, 39)0.221FEV1/predicted value (%)80.8 12.4 (53, 96)43.5 4.7 (32, 63)43.6 5.1 (30, 65) 0.001FEV1/FVC (%)73.5 13.4 (56, 86)55.6 11.4 (43, 72)53.5 12.1 (40, 76) 0.001FVC (%)82.1 20.4 (65, 97)49.2 17.5 (32, 61)40.5 16.7 (26, 58) 0.001PaO2 (mmHg)88.0 6.1 (76.5, 98.5)62.6 8.3 (54.2, 73.6)54.5 4.0 (51.2, 59.7) 0.001PaCO2 (mmHg)44.2 4.2 (36.8, 52.3)60.8 7.6 (51.2, 66.7)66.4 7.6 (58.4, 72.4) 0.001SpO2 decreased by 3% during exercise27 (21.6%)123 (48.3%)105 (85.1%) 0.001D-dimer (g/l)307.5 205.4 (102.5, 495.4)498.4 207.6 (208.6, 603.7)651.7 325.6 (422.8, 982.7) 0.0016MWT/m413.8 45.3 (375.8, 462.1)312.6 39.8 (264.4, 345.7)250.5 36.5 (214.5, 295.6) 0.001DLCO/%88.5 12.3 (70.5, 95.8)56.5 7.8 (44.8, 72.3)55.7 7.6 (45.4, 69.8) 0.001mPAP/mmHg20.1 2.5 (17.9, 23.1)23.5 2.7 (19.2, 24.9)36.7 5.7 (31.6, 43.8) 0.001Pulmonary vascular resistance (WU)1.1 0.3 (0.9, 1.4)2.4 0.5 (2.2, 2.7)4.6 0.7 (4.2, 4.9) 0.001Cardiac output (l/min)5.9 1.1 (5.1, 6.8)6.5 1.2 (5.7, 7.6)6.1 1.4 (5.5, 7.7)0.764Cardiac index (l/min/m2)2.5 0.9 (2.0, 3.9)3.7 1.4 (2.9, 4.9)3.4 1.6 (2.7, 5.3)0.217GFR (ml/min??1.73 m2)87.6 4.1 (48.4, 102.3)78.5 3.6 (45.5, 99.6)62.5 3.1 (37.1, 81.4)0.007RBF (ml/min??1.73 m2)1054.6 65.2 (706.9, 135.4)851.2 42.3 (760.1, 991.3)653.8 33.9 (583.4, 701.4) 0.001 Open in a separate window FVC (minimum, maximum). Abbreviations: GFR, glomerular filtration rate; 6MWT, 6 min walking assessments; RBF, renal blood flow. The correlations between the SNPs of the BNP gene, including the rs198389, rs6668352, and rs198388 loci, and COPD The genotype distributions of the BNP gene SNP loci rs198389, rs6668352, and rs198388 of the subjects in the three groups are shown in Table 3. The percentage of the rs198389 site homozygous mutation of the BNP gene in the COPD group GS-9973 tyrosianse inhibitor was significantly higher than that of the control group (adjusted OR = 1.265, 95% CI = 1.100C1.407, = 0.002), and the risk of COPD in the T allele carriers increased significantly (adjusted OR = 1.145, 95% CI = 1.055C1.232, were high risk GS-9973 tyrosianse inhibitor factors for the COPD patients complicated with PH (adjusted OR = 2.426, 95% CI = 1.992C2.955, gene in the COPD/PH? group and COPD/PH+ group s) gene for the loci rs198389, rs6668352, and rs198388 are shown in Physique 2. According to the results, the content of BNP and Fbg protein in the serum of the heterozygote and mutant homozygote at the gene rs198389, rs6668352, rs198388 loci increased successively, GS-9973 tyrosianse inhibitor while the content of serum Apelin protein decreased successively (resulted in a decrease in serum Apelin protein, which may be one of the causes of the exacerbations of COPD, and thus, it might be used as a potential therapeutic target for COPD with PH. BNP is located on human chromosome 1, which contains three exons and two introns encoding the BNP prohormone precursor [25]. The BNP prohormone precursor is usually synthesized in cardiac myocytes and is usually then processed under shear stress and secreted into the plasma to regulate blood pressure and blood flow to maintain homeostasis [26]. Studies show that plasma BNP levels may be associated with postoperative low cardiac output syndrome in children with congenital heart disease. Approximately 90% PLD1 of PH patients who undergo congenital heart disease surgery have a preoperative plasma BNP higher than 125.5 pg/ml, leading to an increased risk of low cardiac output syndrome [27]. Studies show that an elevated BNP level is usually associated with heart failure and that the detection of the BNP content is expected to be used for clinical heart failure screening [28]. Left ventricular systolic dysfunction (LVSD) and cardiac decompensation are usually accompanied by AECOPD, and studies have shown that NT-proBNP can be used as a diagnostic marker for LVSD in acute exacerbation of COPD [29]. The results of the present study showed that the serum BNP.