Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China.
Sci Rep. 2024 Mar 18;14(1):6508. doi: 10.1038/s41598-024-56747-2.
Chronic obstructive pulmonary disease (COPD) combined with malnutrition results in decreased exercise capacity and a worse quality of life. We aimed to develop an observational case-control study to explore the effective and convenient method to identify potential individuals is lacking. This study included data from 251 patients with COPD and 85 participants in the control group. Parameters and body composition were compared between groups, and among patients with varied severity. The LASSO approach was employed to select the features for fitting a logistic model to predict the risk of malnutrition in patients with stable COPD. Patients with COPD exhibited significantly lower 6-min walk distance (6MWD), handgrip strength, fat-free mass index (FFMI), skeletal muscle mass (SMM) and protein. The significant predictors identified following LASSO selection included 6MWD, waist-to-hip ratio (WHR), GOLD grades, the COPD Assessment Test (CAT) score, and the prevalence of acute exacerbations. The risk score model yielded good accuracy (C-index, 0.866 [95% CI 0.824-0.909]) and calibration (Brier score = 0.150). After internal validation, the adjusted C-index and Brier score were 0.849, and 0.165, respectively. This model may provide primary physicians with a simple scoring system to identify malnourished patients with COPD and develop appropriate rehabilitation interventions.
慢性阻塞性肺疾病（COPD）合并营养不良会导致运动能力下降和生活质量下降。我们旨在开展一项观察性病例对照研究，以探索识别潜在个体的有效且方便的方法，但目前这种方法仍存在欠缺。本研究纳入了 251 例 COPD 患者和 85 名对照组参与者的数据。比较了两组之间以及不同严重程度的患者之间的参数和身体成分。采用 LASSO 方法选择特征，拟合逻辑模型以预测稳定期 COPD 患者发生营养不良的风险。COPD 患者的 6 分钟步行距离（6MWD）、握力、去脂体重指数（FFMI）、骨骼肌质量（SMM）和蛋白显著降低。LASSO 选择后的显著预测因素包括 6MWD、腰臀比（WHR）、GOLD 分级、COPD 评估测试（CAT）评分和急性加重的发生率。风险评分模型具有较好的准确性（C 指数为 0.866 [95%CI 0.824-0.909]）和校准（Brier 评分=0.150）。内部验证后，调整后的 C 指数和 Brier 评分分别为 0.849 和 0.165。该模型可为初级保健医生提供一种简单的评分系统，以识别患有 COPD 的营养不良患者，并制定适当的康复干预措施。
