慢性阻塞性肺疾病与体质量指数、甘油三酯、胆固醇的相关性研究

Study on the correlation between body mass index,triglyceride and total cholesterol in patients with chronic obstructive pulmonary disease

目的探究慢性阻塞性肺疾病(COPD)与体质量指数(BMI)、甘油三酯、总胆固醇之间的关系。方法纳入2018年1月至12月在长沙市第四医院呼吸内科门诊及住院稳定期的COPD患者,测定BMI、甘油三酯、总胆固醇,同时回顾性记录上一年度患者急性加重的次数,联合使用慢性阻塞性肺疾病评估测试评分,根据慢性阻塞性肺疾病全球倡议指南分类标准将患者分为A、B、C、D 4组,分析各组患者BMI、甘油三酯、胆固醇的关系。同时分析BMI<25 kg/m^(2)组的患者急性加重和BMI、甘油三酯、胆固醇的关系。结果该研究共纳入116例COPD患者,其中男104例,女12例,对比4组患者各自的BMI、甘油三酯、胆固醇相关参数差异均无统计学意义(P值均>0.05)。在总患者人群中,BMI、甘油三酯、胆固醇和急性加重无明显相关,而在BMI<25 kg/m^(2)亚组中,甘油三酯(OR=10.364,P=0.035)和胆固醇(OR=2.506,P=0.025)是急性加重的危险因素,而BMI是急性加重的保护因素(OR=0.283,P=0.034),BMI越高,急性加重风险越低。结论在BMI<25 kg/m^(2)的患者中,BMI、甘油三酯、胆固醇可能与COPD急性加重风险相关。

Objective To investigate the relationship between body mass index(BMI),triglyceride(TG)and total cholesterol(TC)in patients with chronic obstructive pulmonary disease(COPD).Methods Patients with stable COPD were enrolled in the Department of Respiratory Medicine,the Forth Hospital of Changsha.BMI,TG and TC related results were measured,and based on the COPD assessment test scores and history of moderate to severe exacerbation and/or episodes of hospitalization in the previous year,the patients in the retrospective cohort were classified into the Global Initiative for Chronic Obstructive Lung Disease A,B,C,and D subgroups,and the relationship between BMI,triglyceride and cholesterol in each group was analyzed.At the same time,the relationship between acute exacerbation and BMI,TG and TC in patients with BMI<25 kg/m^(2) was analyzed.Results A total of 116 patients with stable COPD were enrolled,in whom 104 cases were men,and 12 cases were women.The BMI,TG and TC showed no significant diferent with A,B,C and D groups(all P>0.05).Patients were stratified according to different BMI,and patients with BMI<25 kg/m^(2) were analyzed in detail.In the whole cohort,the BMI,TG and TC showed no significant association with risk of acute exacerbation of COPD,but increased TG(OR=10.364,P=0.035)and TC(OR=2.506,P=0.025)showed a significant association with an increased risk of an acute exacerbation of COPD in the subgroup with a BMI<25 kg/m^(2).The BMI showed a minimally protective effect and reduced risk of acute exacerbation of COPD in the lower BMI subgroup(OR=0.283,P=0.034).Conclusions In the subgroup with a BMI<25 kg/m^(2),the BMI,TG and TC was positively correlated with the risk of occurrence of acute exacerbations of COPD.