Iran Medical Council Journal of Iranian Medical Council 2645-338X 8 2 2025 04 01 Association between Serum Bilirubin Levels and Acute Exacerbation in Patients with Chronic Obstructive Pulmonary Disease 276 283 214670 10.18502/jimc.v8i2.17699 EN Maryam Najafpour Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Mahnaz Mozdourian Lung Diseases Research Center, Mashhad University of Medical Science, Mashhad, Iran Shima Nabavi Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Farnoosh Ebrahimzadeh Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Hassan Mehrad-Majd Clinical Research Development Unit, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Cancer Molecular Pathology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Journal Article 2024 02 28 <strong>Background:</strong> The literature on the potential protective role of serum bilirubin levels in the development of Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) has produced conflicting findings. This study aimed to investigate the potential relationship between serum total and direct bilirubin levels and the risk of acute exacerbation in COPD. <br><strong>Methods:</strong> Over a period of 18 months, a total of 99 patients were recruited from two major hospitals in Mashhad, Iran, comprising 49 individuals with stable COPD and 50 with AECOPD. After obtaining informed consent and conducting a comprehensive medical history and physical examination, both groups underwent an assessment of various laboratory indices, such as total and direct bilirubin levels. Appropriate statistical analysis was applied to assess the potential associations between bilirubin concentrations and the risk of AECOPD. <br><strong>Results: </strong>The study population had a mean age of 64.97±10.12 years, and there was no significant difference in gender distribution (p=0.546). The majority of subjects (55.6%) were male. The serum levels of AST and ALT were significantly higher in the AECOPD group (p<0.001). Additionally, although there were no significant differences in total bilirubin levels between the two groups (p=0.323), there was a significantly higher level of direct bilirubin in the AECOP group (p<0.001). <br><strong>Conclusion:</strong> Serum direct bilirubin levels were higher in COPD patients with acute exacerbation. It may be an independent biomarker for screening the COPD patients with and without acute exacerbation. Further studies are required to validate the findings.<br><br> https://www.jimc.ir/article_214670_f7cb0be634eb479eae6ad0717786fd46.pdf