肌少症性肥胖对慢性阻塞性肺疾病的临床影响：一项横断面研究。

Clinical impacts of sarcopenic obesity on chronic obstructive pulmonary disease: a cross-sectional study.

机构信息

National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.

Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.

出版信息

BMC Pulm Med. 2023 Oct 18;23(1):394. doi: 10.1186/s12890-023-02702-2.

DOI:10.1186/s12890-023-02702-2

PMID:37853348

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10585792/

Abstract

BACKGROUND

Sarcopenia and obesity are two abnormal body composition phenotypes, and sarcopenic obesity (SO) is characterized by both low skeletal muscle mass (sarcopenia) and high adiposity (obesity). SO negatively influences the clinical status of patients with chronic obstructive pulmonary disease (COPD). However, the studies exploring the prevalence and clinical effects of SO in COPD patients are limited. Our study aimed to elucidate the prevalence and impact of SO on COPD patients.

METHODS

In this cross-sectional study, the pulmonary function, St. George's Respiratory Questionnaire, exercise tolerance, body composition, and serum levels of resistin and TNF-α were assessed in 198 COPD patients. The clinical value of serum resistin and TNF-α for predicting SO in patients with COPD was evaluated.

RESULTS

In the 198 patients with COPD, the prevalence rates of sarcopenia, obesity, and SO in COPD patients were 27.27%, 29.8%, and 9.6%, respectively. Patients with SO experienced more severe symptoms of dyspnea and worse health related quality of life. The expression of resistin increased in patients with SO compared to other patients. The AUC value of serum resistin level for predicting SO was 0.870 (95% CI: 0.799-0.940). BMI (OR: 1.474, 95% CI: 1.124-1.934) and resistin (OR: 1.001, 95% CI: 1.000-1.002) levels were independent risk factors of SO in patients with COPD in Multivariate analysis.

CONCLUSION

The prevalence rates of SO in COPD patients was 9.6%. COPD accompanied by SO is significantly associated with worse pulmonary function and poor physical performance. Serum resistin may be a potential adjunct for predicting SO in COPD patients.

摘要

背景

肌少症和肥胖是两种异常的身体成分表型，肌少症合并肥胖（SO）的特征是低骨骼肌质量（肌少症）和高体脂率（肥胖）。SO 对慢性阻塞性肺疾病（COPD）患者的临床状况有负面影响。然而，研究探索 COPD 患者中 SO 的患病率和临床影响的研究有限。我们的研究旨在阐明 SO 在 COPD 患者中的患病率和影响。

方法

在这项横断面研究中，对 198 例 COPD 患者的肺功能、圣乔治呼吸问卷、运动耐量、身体成分以及血清抵抗素和 TNF-α水平进行了评估。评估了血清抵抗素和 TNF-α对预测 COPD 患者 SO 的临床价值。

结果

在 198 例 COPD 患者中，COPD 患者中肌少症、肥胖和 SO 的患病率分别为 27.27%、29.8%和 9.6%。SO 患者呼吸困难症状更严重，健康相关生活质量更差。与其他患者相比，SO 患者的抵抗素表达增加。血清抵抗素水平预测 SO 的 AUC 值为 0.870（95%CI：0.799-0.940）。BMI（OR：1.474，95%CI：1.124-1.934）和抵抗素（OR：1.001，95%CI：1.000-1.002）水平是 COPD 患者 SO 的独立危险因素。