炎症和基于营养的指标与慢性阻塞性肺病和死亡率的关联
Kaiqiang Cao1, Xiaoyang Miao2, Xiaorong Chen3
1Department of Emergency, the First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, China.
Journal of health, population, and nutrition
|December 6, 2024
概括
炎症和营养指标影响慢性阻塞性肺病 (COPD) 的风险和生存率. 营养风险 (RAR) 强烈预测COPD死亡率,而其他标志物如PNI和HALP显示保护性关联.
科学领域:
- 呼吸系统医学 呼吸系统医学
- 营养科学 营养科学
- 公共卫生 公共卫生
背景情况:
- 炎症和营养状况是影响呼吸系统健康的公认因素.
- 炎症和基于营养的指标与慢性阻塞性肺病 (COPD) 的患病率和死亡率之间的具体关系仍未得到充分研究.
研究的目的:
- 调查各种炎症和基于营养的指标与COPD的患病率之间的联系.
- 检查这些指标与COPD患者全因死亡率之间的联系.
- 确定COPD死亡率的最强有力的预测指标.
主要方法:
- 从NHANES 1999-2018中分析了46 572名成年人 (年龄≥20岁) 的数据.
- 炎症和营养指标的评估:中性粒细胞与白蛋白的比率 (NAR),预后营养指数 (PNI),单细胞与白蛋白的比率 (MAR),红细胞分布宽度与白蛋白的比率 (RAR),血红蛋白,白蛋白,淋巴细胞和血小板评分 (HALP) 和白蛋白与脂质的比率 (ALI).
- 通过自我报告问卷诊断COPD;与国家死亡指数相关的死亡率数据.
主要成果:
- NAR,MAR和RAR与COPD患病率有积极的关联.
- PNI和HALP显示与COPD患病率存在负面关联.
- 在COPD患者中,较高的NAR,MAR和RAR与全因死亡率的增加有关 (HRs1.43-2.45),而较高的PNI和HALP与死亡率的降低有关 (HRs0.48-0.56).
- 随机生存森林发现RAR是COPD全因死亡率最强的预测因素.
结论:
- 炎症和基于营养的指标与COPD患者的预后有显著的关联.
- 红细胞分布宽度与白蛋白比率 (RAR) 显示了COPD死亡率的最高预测值.
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