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慢性阻塞性肺疾病中肌肉减少症与代谢综合征的关联:2008年至2011年韩国国家健康与营养检查调查(KNHANES)

Association between sarcopenia and metabolic syndrome in chronic obstructive pulmonary disease: the Korea National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2011.

作者信息

Chung Jae Ho, Hwang Hee-Jin, Han Chang Hoon, Son Bong Soo, Kim Do Hyung, Park Moo Suk

机构信息

1Division of Pulmonology, Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong Univerisity College of Medicine , Incheon , Korea.

出版信息

COPD. 2015 Feb;12(1):82-9. doi: 10.3109/15412555.2014.908835. Epub 2014 Jun 10.

Abstract

AIM

It is not clear whether the restrictive or obstructive pattern of spirometry is associated with metabolic syndrome. We investigated the associations between restrictive and obstructive spirometric patterns and metabolic risk factors using data from the Korea National Health and Nutrition Examination Survey (KNHANES). Additionally, we investigated whether sarcopenia is associated with metabolic syndrome in patients with chronic obstructive pulmonary disease (COPD).

METHODS

Using data from KNHANES between 2008 and 2011, we enrolled 8,145 subjects (normal lung function: 6,077, obstructive spirometric pattern: 1,039, restrictive pattern: 1,029) aged ≥40 years who underwent anthropometric measurement, laboratory tests, spirometry and estimation of appendicular muscle mass. Sarcopenia was defined as an appendicular skeletal muscle mass divided by body weight squared <2 SD below the sex-specific mean for the young reference group.

RESULTS

Sarcopenia was found in 32.8% of male and 12.2% of female patients with COPD. The odds ratio (OR) of metabolic syndrome for the restrictive spirometric pattern in male was 1.29 (95% confidence interval [CI], 1.02-1.65), and that for obstructive pattern in males was 0.99 (95% CI, 0.79-1.26) after adjustments for covariables (female restrictive pattern (ORs, 1,45; 95% CI, 1.09-1.91) and female obstructive pattern (ORs 0.73; 95% CI, 0.49-1.09). After adjustment for other confounding factors, the risk of metabolic syndrome was higher in sarcopenic male (OR, 1.88; 95% CI, 1.27-2.77) with COPD than in those without sarcopenia.

CONCLUSIONS

The restrictive spirometric pattern is associated with metabolic syndrome, and sarcopenia may contribute to the risk of metabolic syndrome in male patients with COPD.

摘要

目的

目前尚不清楚肺量计的限制性或阻塞性模式是否与代谢综合征相关。我们利用韩国国家健康与营养检查调查(KNHANES)的数据,研究了限制性和阻塞性肺量计模式与代谢危险因素之间的关联。此外,我们还研究了肌肉减少症与慢性阻塞性肺疾病(COPD)患者代谢综合征之间是否存在关联。

方法

利用2008年至2011年KNHANES的数据,我们纳入了8145名年龄≥40岁的受试者(肺功能正常:6077名,阻塞性肺量计模式:1039名,限制性模式:1029名),这些受试者接受了人体测量、实验室检查、肺量计检查和四肢肌肉质量评估。肌肉减少症的定义为四肢骨骼肌质量除以体重平方低于年轻参考组特定性别的平均值2个标准差。

结果

在COPD男性患者中,32.8%存在肌肉减少症,女性患者中这一比例为12.2%。在对协变量进行调整后,男性限制性肺量计模式的代谢综合征优势比(OR)为1.29(95%置信区间[CI],1.02 - 1.65),男性阻塞性模式的OR为0.99(95% CI,0.79 - 1.26)(女性限制性模式(OR为1.45;95% CI,1.09 - 1.91)和女性阻塞性模式(OR为0.73;95% CI,0.49 - 1.09))。在对其他混杂因素进行调整后,COPD男性肌肉减少症患者发生代谢综合征的风险(OR,1.88;95% CI,1.27 - 2.77)高于无肌肉减少症的患者。

结论

限制性肺量计模式与代谢综合征相关,肌肉减少症可能会增加男性COPD患者发生代谢综合征的风险。

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