Body Mass Index and Lung Function in Hospitalized Severe AECOPD Patients: Investigating Nonlinear Associations and the Role of Hemoglobin.

IF 2.7 3区 医学 Q2 RESPIRATORY SYSTEM
Cong Zhang, Wenhao Ling, He Pan, Rui Bai, Li He
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引用次数: 0

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of global morbidity and mortality. Patients hospitalized with severe acute exacerbations of COPD (AECOPD) represent a high-risk group with poor outcomes and accelerated lung function decline. Body mass index (BMI) shows inconsistent associations with lung function across populations, and its role in AECOPD remains unclear. Understanding this relationship may improve clinical management. Hemoglobin (Hb), essential for oxygen transport, may further influence this association through physiological mechanisms. This study aimed to explore the relationship between BMI and lung function in hospitalized patients with severe AECOPD and to assess whether BMI influences length of hospital stay (LOHS), while evaluating the potential modifying role of Hb.

Methods: A retrospective, single-center cross-sectional study was conducted among 579 patients hospitalized for severe AECOPD from 2021 to 2023. Data on BMI, lung function, Hb levels, and LOHS were collected. Nonlinear and threshold effect analyses were used to explore associations between BMI and lung function or LOHS. Subgroup analyses assessed the modifying effect of Hb.

Results: BMI exhibited a nonlinear positive association with FEV1, FVC, FEV1% predicted, and FVC% predicted. Thresholds were identified at 25.39 kg/m² for FEV1, 26.23 kg/m² for FEV1% predicted, 21.67 kg/m² for FVC, and 22.19 kg/m² for FVC% predicted. The association was more pronounced in patients with higher Hb levels. No significant association was found between BMI and LOHS, suggesting that other factors such as infection severity, comorbidities, or treatment strategies may may exert greater influence.

Conclusion: A nonlinear, inverse L-shaped association was observed between BMI and lung function, further modified by Hb levels. These findings highlight the importance of individualized treatment and stratification strategies in severe AECOPD. Future longitudinal studies are needed to validate these observations.

住院重症AECOPD患者的体重指数和肺功能:探讨非线性关联和血红蛋白的作用。
背景:慢性阻塞性肺疾病(COPD)是全球发病率和死亡率的主要原因。慢性阻塞性肺病严重急性加重(AECOPD)住院患者是预后不良和肺功能加速衰退的高危人群。身体质量指数(BMI)与肺功能的相关性在人群中并不一致,其在AECOPD中的作用尚不清楚。了解这种关系可以改善临床管理。血红蛋白(Hb)对氧气运输至关重要,可能通过生理机制进一步影响这种关联。本研究旨在探讨重度AECOPD住院患者BMI与肺功能的关系,并评估BMI是否影响住院时间(LOHS),同时评估Hb的潜在调节作用。方法:对579例2021 - 2023年住院的重症AECOPD患者进行回顾性、单中心横断面研究。收集BMI、肺功能、Hb水平和LOHS数据。非线性和阈值效应分析用于探讨BMI与肺功能或LOHS之间的关系。亚组分析评估了Hb的改善作用。结果:BMI与FEV1、FVC、FEV1%预测值和FVC%预测值呈非线性正相关。FEV1的预测阈值为25.39 kg/m²,FEV1%的预测阈值为26.23 kg/m²,FVC的预测阈值为21.67 kg/m²,FVC%的预测阈值为22.19 kg/m²。这种关联在Hb水平较高的患者中更为明显。BMI与LOHS之间未发现显著关联,提示其他因素,如感染严重程度、合并症或治疗策略可能会产生更大的影响。结论:BMI与肺功能呈非线性负l型关系,并进一步受到Hb水平的影响。这些发现强调了重症AECOPD个体化治疗和分层策略的重要性。需要进一步的纵向研究来验证这些观察结果。
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来源期刊
CiteScore
4.80
自引率
10.70%
发文量
372
审稿时长
16 weeks
期刊介绍: An international, peer-reviewed journal of therapeutics and pharmacology focusing on concise rapid reporting of clinical studies and reviews in COPD. Special focus will be given to the pathophysiological processes underlying the disease, intervention programs, patient focused education, and self management protocols. This journal is directed at specialists and healthcare professionals
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