Bridevaux P-O, Gerbase M W, Schindler C, Dietrich D Felber, Curjuric I, Dratva J, Ackermann-Liebrich U, Probst-Hensch N M, Gaspoz J-M, Rochat T
University Hospitals of Geneva, Division of Pulmonary Medicine, Geneva, Switzerland.
Eur Respir J. 2009 Aug;34(2):332-9. doi: 10.1183/09031936.00162608. Epub 2009 Feb 27.
Systemic inflammation may mediate the association between chronic obstructive pulmonary disease (COPD) and extrapulmonary comorbidities. We measured high-sensitivity C-reactive protein (hs-CRP) in COPD and quantified the effect modification by body weight change and sex. Using data from the Swiss study on Air Pollution and Lung Diseases in Adults (SAPALDIA; n = 5,479) with measurements of forced expiratory volume in 1 s (FEV(1)), body weight and hs-CRP, we examined the association of hs-CRP and categories of body weight change (lost weight and weight gained 0-5%, 5-9%, 9-14% and >14%) with fast FEV(1) decline. hs-CRP was elevated both in association with fast FEV(1) decline and body weight gain. Subjects with fast FEV(1) decline and weight gain (>14%) had higher hs-CRP (2.0 mg L(-1) for females versus 1.6 mg L(-1) for males). After adjustment for age, smoking, physical activity, hormonal therapy and diabetes, elevated hs-CRP (>3 mg) was found to be more likely in subjects with fast FEV(1) decline (OR(males) 1.38, OR(females) 1.42) and in those with weight gain >14% (OR(males) 2.04, OR(females) 4.51). The association of weight gain and fast FEV(1) decline predicts a higher level of systemic inflammation. Since the effect of weight gain on systemic inflammation is larger in females than in males, weight gain may be a risk factor for extrapulmonary comorbidities in females with COPD.
全身炎症可能介导慢性阻塞性肺疾病（COPD）与肺外合并症之间的关联。我们测量了COPD患者的高敏C反应蛋白（hs-CRP），并量化了体重变化和性别对效应的修饰作用。利用瑞士成人空气污染与肺部疾病研究（SAPALDIA；n = 5479）的数据，该研究测量了第1秒用力呼气量（FEV₁）、体重和hs-CRP，我们研究了hs-CRP以及体重变化类别（体重减轻和体重增加0-5%、5-9%、9-14%和>14%）与FEV₁快速下降之间的关联。hs-CRP的升高与FEV₁快速下降和体重增加均相关。FEV₁快速下降且体重增加（>14%）的受试者hs-CRP水平更高（女性为2.0 mg/L，男性为1.6 mg/L）。在调整年龄、吸烟、体育活动、激素治疗和糖尿病因素后，发现FEV₁快速下降的受试者（男性OR为1.38，女性OR为1.42）以及体重增加>14%的受试者（男性OR为2.04，女性OR为4.51）更有可能出现hs-CRP升高（>3 mg）。体重增加与FEV₁快速下降之间的关联预示着全身炎症水平更高。由于体重增加对全身炎症的影响在女性中比在男性中更大，体重增加可能是COPD女性患者发生肺外合并症的一个危险因素。
