Eriksson Berne, Backman Helena, Bossios Apostolos, Bjerg Anders, Hedman Linnea, Lindberg Anne, Rönmark Eva, Lundbäck Bo
Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Dept of Internal Medicine, The Central County Hospital of Halmstad, Halmstad, Sweden.
Dept of Public Health and Clinical Medicine, Division of Occupational and Environmental Medicine/the OLIN Unit, University of Umeå, Umeå, Sweden.
ERJ Open Res. 2016 Jul 7;2(3). doi: 10.1183/23120541.00051-2015. eCollection 2016 Jul.
Low body mass index (BMI) and malnutrition in chronic obstructive pulmonary disease (COPD) are associated with a poor prognosis. The prevalence of underweight, as well as overweight, in severity grades of COPD is sparsely investigated in studies of the general population and the associated patterns of risk factors are not well established. The aim of the present study was to determine the association between severity grades of airflow limitation in COPD, and both underweight and obesity when corrected for possible confounding factors. The study is based on pooled data from the OLIN (Obstructive Lung Disease in Northern Sweden) studies. Complete records with lung function, BMI and structured interview data were available from 3942 subjects (50.7% women and 49.3% men). COPD and severity grading were defined using the Global Initiative for Chronic Obstructive Lung Disease criteria. In sensitivity analyses, the lower limit of normal was used. The prevalence of underweight was 7.3% in severe COPD (grades 3 and 4) 2.0% in those with normal spirometry. The prevalence of obesity increased from 9.7% in grade 1, to 16.3% in grade 2 and 20.0% in severe COPD, 17.7% in those with normal spirometry. In adjusted analysis, of the COPD severity grades, only severe COPD was associated with underweight (OR 3.24, 95% CI 1.0004-10.5), while the COPD severity grades tended to be inversely associated with overweight.
慢性阻塞性肺疾病（COPD）患者的低体重指数（BMI）和营养不良与预后不良相关。在一般人群研究中，对COPD严重程度分级中的体重过轻以及超重的患病率研究较少，且相关危险因素模式尚未明确确立。本研究的目的是确定COPD气流受限严重程度分级与体重过轻和肥胖之间的关联，并校正可能的混杂因素。该研究基于来自瑞典北部阻塞性肺病（OLIN）研究的汇总数据。共有3942名受试者（50.7%为女性，49.3%为男性）提供了完整的肺功能、BMI和结构化访谈数据。COPD及其严重程度分级采用慢性阻塞性肺疾病全球倡议标准进行定义。在敏感性分析中，使用正常下限。重度COPD（3级和4级）患者体重过轻的患病率为7.3%，肺功能正常者为2.0%。肥胖患病率从1级的9.7%升至2级的16.3%，重度COPD为20.0%，肺功能正常者为17.7%。在校正分析中，在COPD严重程度分级中，只有重度COPD与体重过轻相关（比值比3.24，95%可信区间1.0004 - 10.5），而COPD严重程度分级与超重呈负相关趋势。
