Department of Public Health, Juntendo University Graduate School of Medicine, Bunkyo, Tokyo, Japan.
Department of Bioscience, GraduateSchool of Agriculture, Ehime University, Matsuyama, Ehime, Japan.
Sci Rep. 2021 Jan 15;11(1):1531. doi: 10.1038/s41598-020-79860-4.
To clarify how low BMI and weight loss were associated with risk of chronic obstructive pulmonary disease (COPD) mortality, in a large prospective cohort of the general population across Japan, the Japan Collaborative Cohort Study, conducted between 1988 and 2009. A total of 45,837 male residents were observed for a median period of 19.1 years. Self-administered questionnaires, collecting information on BMI, weight loss since the age of 20, lifestyles, history of diseases, as well as records of COPD mortality, were analysed at 2019. During follow-up, 268 participants died from COPD. The multivariate-adjusted hazard ratio (95% confidence interval) of COPD mortality associated with a 1-SD increment of body mass index (BMI) was 0.48 (0.41-0.57), while for weight change from age of 20 (+ 2.0 kg) it was 0.63 (0.59-0.68). These associations were persistently observed after stratifications with smoking status, excluding those having airway symptoms in the baseline survey, and excluding early COPD deaths within 5, 10 and 15 years. Our study suggests that BMI and weight change since the age of 20 could be markers for COPD prognosis, indicated by risk of COPD mortality.
为了阐明低 BMI 和体重减轻与慢性阻塞性肺疾病（COPD）死亡率风险之间的关联，我们在日本一个大型的普通人群前瞻性队列中进行了这项研究，该研究名为日本协作队列研究，于 1988 年至 2009 年进行。共有 45837 名男性居民被观察了中位数为 19.1 年的时间。在 2019 年，通过自我管理问卷收集了 BMI、20 岁以后的体重减轻、生活方式、疾病史以及 COPD 死亡率的记录等信息。在随访期间，有 268 名参与者死于 COPD。与 BMI 增加 1-SD 相关的 COPD 死亡率的多变量调整后的危害比（95%置信区间）为 0.48（0.41-0.57），而与 20 岁以后体重变化（+2.0 公斤）相关的危害比为 0.63（0.59-0.68）。这些关联在分层考虑吸烟状况、排除基线调查中存在气道症状的个体以及排除 COPD 早期死亡（在 5、10 和 15 年内）后仍然存在。我们的研究表明，BMI 和 20 岁以后的体重变化可能是 COPD 预后的标志物，表明 COPD 死亡率的风险。
