Centre for Environment and Population Health, Griffith University, Brisbane, Queensland, Australia.
Obes Rev. 2013 Oct;14(10):839-57. doi: 10.1111/obr.12055. Epub 2013 Jun 25.
The aims of our meta-analysis were to examine the pattern and gender's influence on body mass index (BMI) - pneumonia relationship. Published studies were searched from PubMed, Web of Science, Cochrane Library databases using keywords of pneumonia, BMI and epidemiologic studies. Random-effects analysis was applied to estimate pooled effect sizes from individual studies. The Cochrane Q-test and index of heterogeneity (I(2) ) were used to evaluate heterogeneity, and Egger's test was used to evaluate publication bias. Random-effects meta-regression was applied to examine the pattern and gender's influence on BMI-pneumonia relationship. A total of 1,531 studies were initially identified, and 25 studies finally were included. The pooled relative risk (RR) and meta-regression model revealed a J-shaped relationship between BMI and risk of community-acquired pneumonia (underweight, RR 1.8, 95% confidence interval [CI], 1.4-2.2, P < 0.01; overweight, 0.89, 95%CI, 0.8-1.03, P, 0.1; obesity, 1.03, 95% CI, 0.8-1.3, p. 8) and U-shaped relationship between BMI and risk of influenza-related pneumonia (underweight, RR 1.9, 95% CI, 1.2-3, P < 0.01; overweight, 0.89, 95% CI, 0.79-0.99, P, 0.03; obesity, 1.3, 95% CI, 1.05-1.63, p. 2; morbidity obesity, 4.6, 95% CI, 2.2-9.8, P < 0.01); whereas, no difference in risk of nosocomial pneumonia was found across the BMI groups. Gender difference did not make significant contribution in modifying BMI-pneumonia risk relationship.
我们的荟萃分析旨在探讨体重指数（BMI）与肺炎关系的模式和性别影响。使用肺炎、BMI 和流行病学研究的关键词，从 PubMed、Web of Science、Cochrane Library 数据库中搜索已发表的研究。应用随机效应分析从个体研究中估计合并效应大小。Cochrane Q 检验和异质性指数（I(2)）用于评估异质性，Egger 检验用于评估发表偏倚。应用随机效应荟萃回归检验 BMI 与肺炎关系的模式和性别影响。最初确定了 1531 项研究，最终纳入了 25 项研究。合并相对风险（RR）和荟萃回归模型显示，BMI 与社区获得性肺炎风险之间呈 J 形关系（体重不足，RR1.8，95%置信区间[CI]1.4-2.2，P<0.01；超重，0.89，95%CI1.8-1.03，P<0.01；肥胖，1.03，95%CI1.8-1.3，P=0.8），与流感相关肺炎风险之间呈 U 形关系（体重不足，RR1.9，95%CI1.2-3，P<0.01；超重，0.89，95%CI1.8-1.03，P<0.01；肥胖，1.3，95%CI1.05-1.63，P=0.2；发病肥胖，4.6，95%CI2.2-9.8，P<0.01）；而 BMI 各组之间的医院获得性肺炎风险无差异。性别差异在修正 BMI-肺炎风险关系方面没有显著贡献。
