Montreal Behavioural Medicine Centré, Hôpital du Sacre-Coeur de Montréal, Quebec.
Can Respir J. 2013 Jul-Aug;20(4):237-42. doi: 10.1155/2013/131072. Epub 2013 May 28.
Increased body weight has been associated with worse prognoses for many chronic diseases; however, this relationship is less clear in patients with chronic obstructive pulmonary disease (COPD), with underweight patients experiencing higher morbidity than normal or overweight patients.
To assess the impact of body mass index (BMI) on the risk for COPD exacerbations.
The present study included 115 patients with stable COPD (53% women; mean [± SD] age 67±8 years). Height and weight were measured to calculate BMI. Patients were followed for a mean of 1.8±0.8 years to assess the prospective risk of inpatient-treated exacerbations and outpatient-treated exacerbations, all of which were verified by chart review.
Cox regression models revealed that underweight patients were at greater risk for inhospital-treated exacerbations (RR 2.93 [95% CI 1.27 to 6.76) relative to normal weight patients. However, overweight (RR 0.59 [95% CI 0.33 to 1.57) and obese (RR 0.99 [95% CI 0.53 to 1.86]) patients did not differ from normal weight patients. All analyses were adjusted for age, sex, length of diagnosis, smoking pack-years, forced expiratory volume in 1 s, and time between recruitment and last exacerbation. BMI did not influence the risk of out-of-hospital exacerbations.
The present study showed that underweight patients were at greater risk for inhospital exacerbations. However, BMI did not appear to be a risk factor for out-of-hospital exacerbations. This suggests that the BMI-exacerbation link may differ according to the nature of the exacerbation, the mechanisms for which are not yet known.
体重增加与许多慢性疾病的预后较差有关；然而，这种关系在慢性阻塞性肺疾病（COPD）患者中不太明确，体重过轻的患者比正常或超重患者的发病率更高。
评估体重指数（BMI）对 COPD 加重风险的影响。
本研究纳入了 115 例稳定期 COPD 患者（53%为女性；平均[±标准差]年龄 67±8 岁）。测量身高和体重以计算 BMI。对患者进行了平均 1.8±0.8 年的随访，以评估住院治疗加重和门诊治疗加重的前瞻性风险，所有这些都通过图表审查进行了验证。
Cox 回归模型显示，与正常体重患者相比，体重过轻患者发生住院治疗加重的风险更高（RR 2.93[95%CI 1.27 至 6.76）。然而，超重（RR 0.59[95%CI 0.33 至 1.57）和肥胖（RR 0.99[95%CI 0.53 至 1.86）患者与正常体重患者无差异。所有分析均调整了年龄、性别、诊断时间、吸烟包年数、1 秒用力呼气量和招募与最近一次加重之间的时间。BMI 不影响门诊加重的风险。
本研究表明，体重过轻的患者发生住院加重的风险更高。然而，BMI 似乎不是门诊加重的危险因素。这表明 BMI-加重的关联可能因加重的性质而异，而其机制尚不清楚。
