Cao Kaiqiang, Miao Xiaoyang, Chen Xiaorong
Department of Emergency, the First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, China.
Department of Intensive Care Unit, , the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
J Health Popul Nutr. 2024 Dec 6;43(1):209. doi: 10.1186/s41043-024-00709-x.
Inflammation and nutrition are strongly linked to respiratory diseases, but the link between inflammation and nutrition-based indicators and chronic obstructive pulmonary disease (COPD) and its mortality has not been reported.
We recruited adults no younger than 20 years old from the NHANES 1999-2018. Inflammation and nutrition-based indicators included NAR, PNI, MAR, RAR, HALP, and ALI. COPD were assessed through a self-report questionnaire. Participants' mortality rates were determined by association with the National Death Index.
A total of 46,572 individuals were collected in this study, including 1,549 COPD patients. NAR, MAR, and RAR were positively linked with the prevalence of COPD. However, PNI and HALP were negatively linked with the prevalence of COPD. In participants with COPD, the highest quartile of NAR (HR = 1.43 [1.04-1.97]), MAR (HR = 1.66 [1.23-2.26]), and RAR (HR = 2.45 [1.90-3.17]) were linked with an increased risk of all-cause mortality compared to the lowest quartile. However, the highest quartile of PNI (HR = 0.48 [0.38-0.61]) and HALP (HR = 0.56 [0.44-0.71]) were linked with a decreased risk of all-cause mortality compared to the lowest quartile. Randomized survival forests (RSF) showed that RAR had the strongest predictive power for all-cause mortality in COPD individuals among all indicators.
We found that inflammation and nutrition-based indicators were linked to prognosis in COPD patients, with RAR having the highest predictive value.
炎症与营养与呼吸系统疾病密切相关，但炎症和基于营养的指标与慢性阻塞性肺疾病（COPD）及其死亡率之间的联系尚未见报道。
我们从1999 - 2018年美国国家健康与营养检查调查（NHANES）中招募了年龄不小于20岁的成年人。基于炎症和营养的指标包括中性粒细胞与淋巴细胞比值（NAR）、预后营养指数（PNI）、淋巴细胞与单核细胞比值（MAR）、红细胞与淋巴细胞比值（RAR）、血清视黄醇结合蛋白（HALP）和白蛋白与球蛋白比值（ALI）。通过自我报告问卷评估COPD。通过与国家死亡指数关联来确定参与者的死亡率。
本研究共收集了46572人，其中包括1549例COPD患者。NAR、MAR和RAR与COPD的患病率呈正相关。然而，PNI和HALP与COPD的患病率呈负相关。在COPD患者中，与最低四分位数相比，NAR（风险比[HR]=1.43[1.04 - 1.97]）、MAR（HR = 1.66[1.23 - 2.26]）和RAR（HR = 2.45[1.90 - 3.17]）的最高四分位数与全因死亡率风险增加相关。然而，与最低四分位数相比，PNI（HR = 0.48[0.38 - 0.61]）和HALP（HR = 0.56[0.44 - 0.71]）的最高四分位数与全因死亡率风险降低相关。随机生存森林（RSF）显示，在所有指标中，RAR对COPD个体的全因死亡率具有最强的预测能力。
我们发现基于炎症和营养的指标与COPD患者的预后相关，其中RAR具有最高的预测价值。
