基于倾向值匹配的慢性呼吸系统疾病对体成分的影响研究

Study on the effect of chronic respiratory diseases on body composition based on propensity value matching

目的探讨慢性呼吸系统疾病与体成分的关系。方法选取新疆和田地区墨玉县参与"新疆多民族自然人群队列建设研究"的人群作为研究对象,以慢性呼吸系统各类疾病者作为病例组,以其他人作为对照组,共建立3个模型分析呼吸系统疾病对体成分的影响。模型1为慢性呼吸系统疾病对体成分影响的单因素线性回归分析;模型2为调整了年龄、性别、体力活动、糖尿病、心血管病、消化性溃疡、骨质疏松7个变量后进行多因素线性回归分析;模型3是在病例组与对照组按照倾向值1∶1匹配后再进行单因素回归分析。最后,进行不同类型疾病的亚组分析。结果共纳入10 337人,患有呼吸系统疾病的有2 323人(22.47%),匹配后病例组和对照组分别为2 199人。模型1显示,慢性呼吸系统疾病与体成分各指标之间无关联(P>0.05),模型2显示,慢性呼吸系统疾病使得去脂体重指数(FFMI)相对降低0.002(P<0.05),模型3显示,匹配后慢性呼吸系统疾病使得体质指数(BMI)、FFMI、肌肉质量指数分别相对降低0.779、3.306、0.057,而脂肪质量(FM)与脂肪质量指数(FMI)分别相对增加1.681、1.010。亚组分析显示,慢性阻塞性肺疾病、支气管哮喘与体成分各指标之间均有关联(P<0.05)。结论慢性呼吸系统疾病与体成分分布有关,脂肪含量相对升高,去脂成分与肌肉含量相对降低,可能会增加呼吸肌耐力及运动能力降低的风险,应尽早采取干预措施延缓疾病进展,提高生活质量。

Objective To explore the effects of chronic respiratory diseases on human body components. Methods The population of Moyu, Hetian, Xinjiang participated in the "Xinjiang multi-ethnic cohort study" as the research object. The patients with chronic respiratory diseases were used as case group, while others were used as control group. Three models were established to analyze the respiratory system. Model 1 is a single factor linear regression analysis of the effects of chronic respiratory diseases on body composition;Model 2 is a Multiple linear regression analysis after adjusting for age, gender, physical activity, diabetes, cardiovascular disease, peptic ulcer and osteoporosis;Model 3 is a single factor regression analysis after the case group and the control group matching based on the tendency value as 1∶1. Finally, sub-group analysis of different types of diseases is carried out. Results The total number of patients with respiratory diseases was 2 323(22.47 %), compared with 2 199 in the case group and control group respectively. Model 1 shows that there is no correlation between chronic respiratory diseases and body components(P>0.05);model 2 shows that chronic respiratory disease causes a relative reduction of FFMI by 0.002(P<0.05);model 3 shows that after the match of chronic respiratory diseases, BMI, FFMI, and muscle mass index decreased by 0.779, 3.306, and 0.057, respectively, while fat quality(FM) and fat quality index FMI increased by 1.681 and 1.010. Sub-group analysis shows that there is a correlation between chronic obstructive pulmonary disease, bronchial asthma, and body composition(P<0.05). Conclusion Chronic respiratory diseases affect the distribution of body components, so that the relative increase in fat content, the relative decrease in the content of fat and muscle components, may increase the risk of reduced respiratory muscle endurance and exercise ability, which should take early intervention measures to delay the disease progression and improve the quality of life.