Department of Respiratory and Critical Care Medicine, Key Laboratory of Respiratory Disease of Ningbo, The First Affiliated Hospital of Ningbo University, Ningbo, China.
Department of Ultrasound, The First Affiliated Hospital of Ningbo University, Ningbo, China.
BMC Pulm Med. 2024 Aug 20;24(1):399. doi: 10.1186/s12890-024-03211-6.
The objective of this study was to investigate the potential association between the inflammatory burden index (IBI) and the prevalence of chronic inflammatory airway diseases (CIAD), as well as mortality rates among individuals diagnosed with CIAD.
Participants were sourced from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2010. The IBI was calculated using the formula: IBI = C-reactive protein * neutrophils / lymphocytes. CIAD comprised self-reported asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). Mortality outcomes, including all-cause and respiratory disease mortality, were determined through linked data from the National Death Index (NDI) up to December 2019.
A total of 27,495 adults were included. IBI was divided into quartiles, with the lowest quartile as the reference group. After adjusting for confounding variables, a positive correlation was observed between higher IBI and increased prevalence of total CIAD (OR = 1.383 [1.215-1.575]), asthma (OR = 1.267 [1.096-1.465]), chronic bronchitis (OR = 1.568 [1.263-1.946]), and COPD (OR = 1.907 [1.311-2.774]). Over a median follow-up of 12.33 [9.92-16.00] years, there were 1221 deaths from all causes and 220 deaths from respiratory disease among 4499 patients with CIAD. Following multivariate adjustments, the fourth quartile was significantly associated with increased risk of all-cause mortality (HR = 2.227 [1.714-2.893]) and respiratory disease mortality (HR = 2.748 [1.383-5.459]) compared to the first quartile of IBI in CIAD participants. Moreover, variable importance analysis using a random survival forest model demonstrated the significance of IBI in predicting mortality from both all-cause and respiratory diseases.
IBI exhibited an association with the prevalence of CIAD, with higher IBI levels correlating with elevated all-cause and respiratory disease mortality among individuals with CIAD.
本研究旨在探讨炎症负担指数（IBI）与慢性炎症气道疾病（CIAD）患病率之间的潜在关联，以及 CIAD 患者的死亡率。
研究对象来自于 1999 年至 2010 年期间进行的国家健康与营养调查（NHANES）。使用公式计算 IBI：IBI=C-反应蛋白*中性粒细胞/淋巴细胞。CIAD 包括自我报告的哮喘、慢性支气管炎和慢性阻塞性肺疾病（COPD）。通过与国家死亡指数（NDI）的数据进行链接，确定截至 2019 年 12 月的全因和呼吸疾病死亡率等死亡结局。
共纳入 27495 名成年人。将 IBI 分为四组，最低组为参考组。在调整了混杂变量后，发现较高的 IBI 与 CIAD 总患病率的增加呈正相关（OR=1.383[1.215-1.575]），哮喘（OR=1.267[1.096-1.465]），慢性支气管炎（OR=1.568[1.263-1.946]）和 COPD（OR=1.907[1.311-2.774]）。在中位随访 12.33[9.92-16.00]年期间，4499 例 CIAD 患者中有 1221 例死于全因，220 例死于呼吸疾病。经过多变量调整后，第四组与 CIAD 患者全因死亡率（HR=2.227[1.714-2.893]）和呼吸疾病死亡率（HR=2.748[1.383-5.459]）的增加显著相关，与 IBI 的第一组相比。此外，使用随机生存森林模型的变量重要性分析表明，IBI 对全因和呼吸疾病死亡率的预测具有重要意义。
IBI 与 CIAD 的患病率相关，较高的 IBI 水平与 CIAD 患者的全因和呼吸疾病死亡率升高相关。
