体质量指数与ARDS发病率的荟萃分析

Body mass index in the morbidity of acute respiratory distress syndrome：a meta-analysis

目的 采用荟萃分析的方法系统评价体质量指数 （ bodymassindex , BMI ）对 ARDS发病率 的 影 响。方 法 以 “ obeseoroverweightorbody massindexorBMI ”和 “ ARDSoracuterespiratorydistresssyndrome ” 为 关 键 词, 计 算 机 检 索 Pubmed 、 EMBASE 、 Cochranedatabases 、Wiley 、 Ovid 、 Medline 、 CNKI、 VIP 、 Wanfang 数据库中关于 BMI 与 ARDS 发病率的相关文献,运用RevMan5.0 及 stata10.0 软件进行荟萃分析。结果 共纳入 14 篇文献,共 29962 例患者。荟萃分析结果显示：肥胖与 ARDS 发病率明显相关 （ OR =1.70 , 95% CI 1.44~2.00 , P ＜0.01 ）。亚组分析结果显示：与正常体质量患者比较,低体质量 （ BMI≤18.5kg / m 2 ）及超重 （BMI25~29.9kg / m2 ）患者 ARDS 发病率差异无统计学意义 （ OR =1.21 , 95% CI 0.72~2.02 , P =0.47 和 OR =1.21 , 95%CI 0.94~1.55 , P =0.13 ）;肥胖患者 （ BMI30-39.9kg / m2和 BMI≥30kg / m2 ） ARDS 发病率较正常体质量患者明显升高 （ BMI30~39.9kg / m 2 ： OR =1.35 , 95% CI 1.12~1.63 , P =0.002 ; BMI≥30kg/ m 2 ： OR =1.75 , 95% CI 1.42~2.15 , P ＜0.01 ）;重度肥胖 （ BMI≥40kg / m 2 ）患者 ARDS 发病率是正常体质量患者的 1.85 倍 （ OR =1.85 , 95% CI 1.40~2.44 , P ＜0.01 ）。结论 BMI 是 ARDS发病的独立危险因素之一。随着 BMI 增加, ARDS 患病率明显升高。

Objective To evaluate body mass index （BMI） in the morbidity of acute respiratory distress syndrome （ARDS）. Methods A systematic search was performed in Pubmed, EMBASE, Cochrane databases, Wiley, Ovid, Medline, CNKI, VIP and Wanfang, using the terms ＂obese or overweight or body mass index or BMI＂ and ＂ARDS or acute respiratory distress syndrome＂. All studies that reported body mass index in the morbidity of acute respiratory distress syndrome were included. A meta-- analysis was performed using RevMan 5.0 and stata 10.0：Results 29 962 patients from 14 studies were included in the meta-analysis. The combined results showed that BMI was associated with the morbidity of ARDS （ OR = 1.70,95% CI 1.44-2.00, P 〈0.01）. Compared to normal weight patients, no significant difference in the morbidity of acute respiratory distress syndrome was observed in underweight and overweight patients （OR ： 1.21, 95% CI 0.72-2.02, P =0.47 and OR ： 1.21, 95% CI 0.94-1.55, P =0.13, respectively）. Our results showed a 35 % and 75 % increase in the morbidity of ARDS in obese patients （BMI 30-39.9 kg/m2 ： OR =1.35,95% CI 1.12-1.63, P =0.002;BMI≥30 kg/m2 ： OR =1.75,95% CI 1.42-2.15, P 〈0.01）. Conclusions The risk of ARDS was higher in severely obese patients than in normal weight patients（ OR =1.85,95% CI 1.40-2.44, P 〈0. 01）. Conclusions：BMI is an independent risk factor for ARDS. High BMI levels are associated with increased risk of ARDS.