慢性阻塞性肺疾病患者全身炎症指数与饮食质量的患病率及预后意义：来自2007 - 2018年美国国家健康与营养检查调查队列研究的证据
Prevalence and Prognostic Significance of Systemic Inflammation Index and Diet Quality in Patients with Chronic Obstructive Pulmonary Disease: Evidence from the Cohort Study of NHANES 2007-2018.
作者信息
Han Yu, Wu Yutao, Li Yihao, Xia Huilin, Cai Zhihao, Qiao Li, Zhang Xiaomeng, Chang Zibei, Huang Peng, Wu Jianqing, Chen Bo
机构信息
Department of Geriatrics, Jiangsu Province Hospital, The First Affiliated Hospital with Nanjing Medical University, Nanjing, People's Republic of China.
Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China.
出版信息
Int J Chron Obstruct Pulmon Dis. 2025 Sep 4;20:3093-3109. doi: 10.2147/COPD.S536178. eCollection 2025.
BACKGROUND
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Previous studies have explored the relationship between different dietary patterns, systemic inflammation index (SII)and the risk of COPD. However, the joint effects and interactions between SII and HEI-2015 in COPD have not been fully investigated. This study aimed to explore the relationships between COPD and SII and HEI-2015.
METHODS
Data from the National Health and Nutrition Examination Surveys (NHANES) were utilized.Univariate and multivariate logistic regression analyzed the associations between SII and HEI-2015 with COPD. Restricted cubic spline (RCS) model analyzed the relationship between SII and HEI-2015 and COPD.Use the area enclosed under the ROC curve (AUC) to represent its predicted value. Interaction indices and subgroup analyses were performed. The Kaplan-Meier curve was used to evaluate the impact on mortality of COPD patients.
RESULTS
This study included 10,898 participants.After adjusting,logistic regression analysis showed that higher SII (OR=1.03, 95% CI: 1.01-1.05) were associated with an increased risk of COPD, while higher HEI-2015 (OR=0.97, 95% CI: 0.96-0.99) reduced the risk.The RCS model observed a non-linear relationship between SII and HEI-2015 and COPD risk. Additionally, ROC showed a more significant advantage in predicting COPD prevalence (AUC=0.68). Interaction analysis indicated that SII and HEI-2015 might be independent influencing factors for COPD risk. Kaplan-Meier survival curves showed a lower all-cause mortality rate among in the group with high SII and low HEI-2015 (p < 0.0001).
CONCLUSION
The results of this study indicate that a higher SII level and a lower HEI-2015 are associated with COPD risk. COPD patients with higher SII levels combined with lower HEI - 2015 levels have a higher all-cause death risk.
背景
慢性阻塞性肺疾病（COPD）是全球第三大死因。以往研究探讨了不同饮食模式、全身炎症指数（SII）与COPD风险之间的关系。然而，SII与2015健康饮食指数（HEI-2015）在COPD中的联合效应及相互作用尚未得到充分研究。本研究旨在探讨COPD与SII及HEI-2015之间的关系。
方法
利用美国国家健康与营养检查调查（NHANES）的数据。单因素和多因素逻辑回归分析SII和HEI-2015与COPD之间的关联。限制立方样条（RCS）模型分析SII和HEI-2015与COPD之间的关系。用ROC曲线下面积（AUC）表示其预测价值。进行交互指数和亚组分析。采用Kaplan-Meier曲线评估对COPD患者死亡率的影响。
结果
本研究纳入10898名参与者。调整后，逻辑回归分析显示较高的SII（OR=1.03，95%CI：1.01-1.05）与COPD风险增加相关，而较高的HEI-2015（OR=0.97，95%CI：0.96-0.99）降低风险。RCS模型观察到SII和HEI-2015与COPD风险之间存在非线性关系。此外，ROC在预测COPD患病率方面显示出更显著的优势（AUC=0.68）。交互分析表明，SII和HEI-2015可能是COPD风险的独立影响因素。Kaplan-Meier生存曲线显示，SII高且HEI-2015低的组全因死亡率较低（p<0.0001）。
结论
本研究结果表明，较高的SII水平和较低的HEI-2015与COPD风险相关。SII水平较高且HEI-2015水平较低的COPD患者全因死亡风险较高。
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