Ruan X N, Xu Q, Wu K, Hou S S, Wang X N, Zhou X, Li Z T, Ke J Z, Liu X L, Chen X D, Liu Q P, Lin T, Fu C W, Wang N
Pudong New District Center for Disease Control and Prevention of Shanghai, Shanghai 200136,China Pudong Preventive Medicine Research Institute,Fudan University, Shanghai 200136, China.
Pudong Preventive Medicine Research Institute,Fudan University, Shanghai 200136, China Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2022 Sep 10;43(9):1441-1447. doi: 10.3760/cma.j.cn112338-20211130-00938.
BMI may play a protective role in reducing the mortality rate of patients with chronic obstructive pulmonary disease (COPD), but its effect on acute exacerbation of COPD remain unclear. Subjects were selected from the COPD patients registration system established in 2014 in Pudong new district, Shanghai. COPD patients from 8 communities were selected by cluster sampling and follow up was conducted prospectively for 18 months. Basic information and BMI were obtained from baseline survey, and acute exacerbations were collected during follow-up. The association between BMI and risk of acute exacerbation was evaluated by using multiple negative binomial regression. Among 328 community COPD patients, 295 who completed the follow up were included in the analysis, in whom 96.3% (284/295) were mild COPD patients. During the follow-up, 11.1% (33/295) of the patients reported acute exacerbation. The results of multiple negative binomial regression suggested that, the risk for acute exacerbation decreased with the increase of BMI (=0.85, 95%:0.73-0.98), overweight patients with BMI ≥25.0 kg/m (0.36, 95%:0.13-0.91) or moderate BMI ( , =0.31, 95%:0.11-0.77) had lower risk for acute exacerbation compared with the patients with normal or low BMI. BMI had a linear correlation with the risk of acute exacerbation. The risk for acute exacerbation in patients with mild or moderate COPD in communities decreased with the increase of BMI, and being overweight might be a protective factor for the acute exacerbation of COPD.
体重指数（BMI）可能在降低慢性阻塞性肺疾病（COPD）患者死亡率方面发挥保护作用，但其对COPD急性加重的影响仍不明确。研究对象选自2014年在上海浦东新区建立的COPD患者登记系统。通过整群抽样从8个社区选取COPD患者，并进行为期18个月的前瞻性随访。从基线调查中获取基本信息和BMI，在随访期间收集急性加重情况。采用多重负二项回归评估BMI与急性加重风险之间的关联。在328例社区COPD患者中，纳入分析的有295例完成随访者，其中96.3%（284/295）为轻度COPD患者。随访期间，11.1%（33/295）的患者报告发生急性加重。多重负二项回归结果表明，急性加重风险随BMI升高而降低（=0.85，95%：0.73 - 0.98），BMI≥25.0 kg/m的超重患者（0.36，95%：0.13 - 0.91）或中等BMI（ ，=0.31，95%：0.11 - 0.77）与BMI正常或较低的患者相比，急性加重风险较低。BMI与急性加重风险呈线性相关。社区中轻度或中度COPD患者的急性加重风险随BMI升高而降低，超重可能是COPD急性加重的一个保护因素。
