体重指数对COPD死亡率的影响:更新的剂量反应元分析
Eric Daniel Tenda1,2,3, Joshua Henrina4,3, Andry Setiadharma4
1Division of Respirology and Critical Care, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia eric.tenda@ui.ac.id.
概括
慢性肺炎患者的肥胖悖论显示,身体质量指数 (BMI) 和死亡率之间存在U形联系. 超重和肥胖与降低死亡率有关,但这种保护作用在较高的BMI下减弱.
科学领域:
- 肺部医学 肺部医学
- 心脏病学 心脏病学
- 流行病学 流行病学
背景情况:
- 肥胖悖论,即较高的体重指数 (BMI) 与在某些条件下更好的结果有关,在慢性阻塞性肺病 (COPD) 中观察到.
- 了解BMI与COPD死亡风险之间的准确关系对于临床管理至关重要.
研究的目的:
- 对BMI与COPD患者的死亡率之间的关联进行更新的元分析.
- 研究BMI对全因,呼吸道和心血管死亡率的特定影响.
主要方法:
- 在Embase,PubMed和Web of Science进行了系统的文献搜索.
- 国际BMI截止值被用来将患者分为体重不足,超重和肥胖的组.
- 全因死亡率是主要结果,呼吸道和心血管死亡率是次要结果.
主要成果:
- 该分析包括120项研究,涉及超过100万名COPD患者.
- 体重不足与死亡率增加有关,而超重和肥胖显示风险降低.
- 在BMI和全因,呼吸道和心血管死亡率之间发现了非线性U形关系,保护作用在特定BMI值之外减少.
结论:
- 这一元分析证实了BMI与COPD患者死亡率之间的U形关系.
- 体重指数对呼吸道和心血管死亡率有很大的影响,而不是对全因死亡率.
- 较高的BMI对死亡率的保护作用在BMI超过所有原因的35.25 kg/m2,呼吸系统的35 kg/m2和心血管死亡率的31 kg/m2时就消失了.
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