Wang Lu, Wang Xiaomin, Chen Dong
Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.
Beijing Geriatric Hospital, Beijing, China.
COPD. 2024 Dec;21(1):2427737. doi: 10.1080/15412555.2024.2427737. Epub 2024 Dec 2.
Chronic obstructive pulmonary disease(COPD) hospitalization heightens risks for patients, including mortality, reduced quality of life, and financial strain. Walking pace (WP) and hand grip strength (HGS) are key indicators, their direct connection to COPD hospitalization is uncertain.
To investigate the relationship between genetic determinants of walking pace, hand grip strength, and the risk of COPD hospitalization as well as lung function.
The data pertaining to WP ( = 459,915), HGS ( = 922,115), COPD hospitalizations ( = 309,154), and lung function ( = 79,055) were procured from comprehensive large-scale genome-wide association studies. In carrying out the causal inference analysis, robust statistical methods were utilized, encompassing inverse variance weighted (IVW), MR-Egger, weighted median, simple median and Weighted mode. To address issues of heterogeneity, pleiotropy, and outliers, we incorporated sensitivity analyses and Mendelian randomization (MR) techniques.
The IVW analysis suggests that a faster WP reduces the risk of COPD hospitalization (OR = 0.3559, 95% CI: 0.22-0.52; = 5.197 × 10). It also reveals a potential association between gait speed and the likelihood of developing early-onset COPD (OR = 0.189, 95% CI 0.09 to 0.39; = 8.89 × 10-6) as well as late-onset COPD (OR = 0.44, 95% CI 0.25 to 0.76; = 0.0036). The IVW analysis further indicates a potential correlation between an increased WP and enhanced peak expiratory flow (PEF) (OR = 1.699, 95% CI: 1.23 to 2.35; = 0.0014), forced expiratory volume in 1 s(FEV1, OR = 1.557, 95% CI 1.24 to 1.95; = 0.0001), and forced vital capacity(FVC, OR = 1.584, 95% CI 1.26 to 1.99; = 8.89 × 10-5). The IVW analysis suggests a possible causal link between stronger left-hand grip strength and elevated levels of FVC (OR = 1.29, 95% CI: 1.15 to 1.46; = 1.68 × 10-5), FEV1 (OR = 1.24, 95% CI: 1.11 to 1.39; = 1.63 × 10-4), and PEF (OR = 1.2, 95% CI: 1.07 to 1.36; = 2.67 × 10-3). Similarly, right-hand grip strength exhibits a comparable causal relationship with FVC and PEF as left-hand grip strength.
Our research shows a link between slower walking pace and higher COPD hospitalization risk, as well as decreased lung function (PEF, FEV1, FVC). We also found a significant correlation between weaker hand grip and reduced lung function, especially FVC. These findings have the potential to improve risk assessment approaches, intervention strategies, and management methods for COPD patients, while simultaneously enhancing their overall quality of life and health status.
慢性阻塞性肺疾病(COPD)住院会增加患者的风险,包括死亡率、生活质量下降和经济负担。步行速度(WP)和握力(HGS)是关键指标,它们与COPD住院之间的直接联系尚不确定。
研究步行速度、握力的遗传决定因素与COPD住院风险以及肺功能之间的关系。
从全面的大规模全基因组关联研究中获取有关WP(n = 459,915)、HGS(n = 922,115)、COPD住院(n = 309,154)和肺功能(n = 79,055)的数据。在进行因果推断分析时,采用了稳健的统计方法,包括逆方差加权(IVW)、MR-Egger、加权中位数、简单中位数和加权模式。为了解决异质性、多效性和异常值问题,我们纳入了敏感性分析和孟德尔随机化(MR)技术。
IVW分析表明,更快的WP可降低COPD住院风险(OR = 0.3559,95% CI:0.22 - 0.52;P = 5.197×10⁻⁵)。它还揭示了步态速度与早发型COPD发生可能性之间的潜在关联(OR = 0.189,95% CI 0.09至0.39;P = 8.89×10⁻⁶)以及晚发型COPD(OR = 0.44,95% CI 0.25至0.76;P = 0.0036)。IVW分析进一步表明,WP增加与呼气峰值流量(PEF)增强之间存在潜在相关性(OR = 1.699,95% CI:1.23至2.35;P = 0.0014)、1秒用力呼气量(FEV1,OR = 1.557,95% CI 1.24至1.95;P = 0.0001)和用力肺活量(FVC,OR = 1.584,95% CI 1.26至1.99;P = 8.89×10⁻⁵)。IVW分析表明,左手握力增强与FVC水平升高之间可能存在因果联系(OR = 1.29,95% CI:1.15至1.46;P = 1.68×10⁻⁵)、FEV1(OR = 1.24,95% CI:1.11至1.39;P = 1.63×10⁻⁴)和PEF(OR = 1.2,95% CI:1.07至1.36;P = 2.67×10⁻³)。同样,右手握力与FVC和PEF之间也表现出与左手握力类似的因果关系。
我们的研究表明,步行速度较慢与COPD住院风险较高以及肺功能下降(PEF、FEV1、FVC)之间存在关联。我们还发现握力较弱与肺功能下降,尤其是FVC下降之间存在显著相关性。这些发现有可能改善COPD患者的风险评估方法、干预策略和管理方法,同时提高他们的整体生活质量和健康状况。