慢性阻塞性肺病的纵向BMI变化和结果:全国性基于人口的队列研究
Taeyun Kim1, Sun Hye Shin2, Hyunsoo Kim3
1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea.
在慢性阻塞性肺病 (COPD) 诊断后减肥显著增加死亡风险,特别是在体重不足的患者中. 监测BMI变化对于管理COPD患者至关重要.
科学领域:
- 肺部医学 肺部医学
- 临床流行病学临床流行病学
背景情况:
- 纵向体重指数 (BMI) 的变化及其对慢性阻塞性肺病 (COPD) 患者临床结果的影响需要进一步调查.
- 了解诊断后的BMI轨迹对于完善COPD管理策略至关重要.
研究的目的:
- 研究COPD患者的纵向BMI变化与临床结果之间的关联,包括全因死亡率和严重恶化.
- 确定COPD诊断后的BMI变化是否预测死亡率和恶化风险.
主要方法:
- 一项回顾性队列研究,涉及116,463名40岁及以上的慢性慢性病患者.
- 从COPD诊断前后 (2014-2019) 至少两次健康检查中BMI百分比变化的分析.
- 评估BMI变化类别 (下降>5%,维持,增加>5%) 和使用调整危险比率 (aHR) 的结果之间的关联.
主要成果:
- 与BMI维持相比,BMI下降 (>5%) 与70%更高的死亡风险 (aHR: 1.70) 和30%更高的严重恶化风险 (aHR: 1.30) 相关.
- 体重指数增加 (>5%) 与13%更高的死亡风险 (aHR: 1.13) 和12%更高的严重恶化风险 (aHR: 1.12) 相联系.
- 在基线BMI较低的患者中,BMI下降显示出较强的死亡相关性;增加的BMI仅在肥胖的COPD患者中与较高的死亡率有关.
结论:
- 在COPD后诊断的BMI显著下降与剂量依赖性相关,与所有原因死亡风险增加有关.
- 体重不足的COPD患者经历BMI下降,死亡风险最高.
- 定期监测体重变化是有效的COPD患者管理的关键组成部分.
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