Tsutsumi Tsubasa, Nakano Dan, Kawaguchi Machiko, Hashida Ryuki, Yoshinaga Shinobu, Takahashi Hirokazu, Anzai Keizo, Kawaguchi Takumi
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan.
Diabetol Metab Syndr. 2022 Aug 16;14(1):115. doi: 10.1186/s13098-022-00887-w.
Metabolic dysfunction and associated systemic inflammation are risk factors for chronic obstructive pulmonary disease (COPD) and COPD is highly prevalent in men. We investigated the impact of metabolic-associated fatty liver disease (MAFLD) and MAFLD-related systemic inflammation on COPD in men.
We enrolled 2,041 men with fatty liver. Patients were classified into the COPD (n = 420/2041) and non-COPD (n = 1621/2041) groups. COPD and its high-risk group were diagnosed using the Japanese Respiratory Society Disease statement. Systemic inflammation was evaluated using the C-reactive protein (CRP)/albumin ratio. Independent factors for COPD were investigated by multivariate analysis and decision-tree analysis.
The prevalence of MAFLD was significantly higher in the COPD group than in the non-COPD group. In multivariable analysis, in addition to heavy smoking and aging, MAFLD was identified as an independent factor for COPD (OR 1.46, 95% CI 1.020-2.101, P = 0.0385). Decision-tree analysis showed that MAFLD, rather than heavy smoking, was the most influential classifier for COPD in non-elderly men (14% in MAFLD vs 6% in non-MAFLD groups). MAFLD was also the second most influential factor in elderly men who were not heavy smokers. In both groups, the CRP/albumin ratio was the first classifier for COPD (16% in the high CRP/albumin ratio group vs 3% in the low CRP/albumin ratio group of non-elderly men).
MAFLD is an independent predictor of COPD in men. MAFLD had a significant impact on COPD through systemic inflammation in men of all ages who were not heavy smokers. MAFLD may be useful to broadly identify COPD in men.
代谢功能障碍及相关的全身炎症是慢性阻塞性肺疾病（COPD）的危险因素，且COPD在男性中高度流行。我们研究了代谢相关脂肪性肝病（MAFLD）及MAFLD相关的全身炎症对男性COPD的影响。
我们纳入了2041例患有脂肪肝的男性患者。将患者分为COPD组（n = 420/2041）和非COPD组（n = 1621/2041）。COPD及其高危组依据日本呼吸学会疾病声明进行诊断。使用C反应蛋白（CRP）/白蛋白比值评估全身炎症。通过多变量分析和决策树分析研究COPD的独立影响因素。
COPD组中MAFLD的患病率显著高于非COPD组。在多变量分析中，除了重度吸烟和衰老外，MAFLD被确定为COPD的独立影响因素（OR 1.46，95%CI 1.020 - 2.101，P = 0.0385）。决策树分析表明，在非老年男性中，MAFLD而非重度吸烟是COPD最具影响力的分类因素（MAFLD组为14%，非MAFLD组为6%）。在不吸烟的老年男性中，MAFLD也是第二大最具影响力的因素。在两组中，CRP/白蛋白比值是COPD的首要分类因素（非老年男性中高CRP/白蛋白比值组为16%，低CRP/白蛋白比值组为3%）。
MAFLD是男性COPD的独立预测因素。在所有年龄段不吸烟的男性中，MAFLD通过全身炎症对COPD有显著影响。MAFLD可能有助于广泛识别男性中的COPD。
