哮喘患者全因死亡率随无脂肪质量指数(FFMI)和脂肪质量指数(FMI)的变化:NHANES 数据库回顾性队列研究的结果。

IF 3.8 4区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Jing Chen, Zihe Cheng, Yang Yao, Shengyu Wang
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引用次数: 0

摘要

背景:哮喘患者的去脂质量指数(FFMI)、脂肪质量指数(FMI)与死亡率之间的关系仍然未知。本研究的目的是在一组确诊患有哮喘的美国成年人中,研究无脂肪质量指数(FFMI)和脂肪质量指数(FMI)与全因死亡率之间的关系:这项研究包括来自 NHANES 的 15,200 名成年人。为了评估死亡率,我们将参与者的记录与国家死亡指数联系起来。我们使用双能 X 射线吸收测定法(DXA)测量并评估了 FMI 和 FFMI。我们使用 Kaplan-Meier 图和对数秩检验探讨了 FFMI 和 FMI 五分位数之间的生存差异,并使用 Schoenfeld 残差评估了比例危险假设。采用 Cox 比例危险度回归模型估算与 FFMI 和 FMI 相关的死亡率危险度比(HRs),并对潜在的混杂因素(包括年龄、性别、吸烟状况、体力活动和其他相关因素)进行调整。此外,还根据理论考虑进行了分层分析,以确定死亡风险较高的亚群。该研究还使用限制性立方样条(RCS)检验了 FFMI、FMI 和死亡率之间的非线性关系:中位随访 184 个月后,12.11% 的人死亡。Kaplan-Meier 图显示,哮喘患者的全因死亡率在 FFMI 和 FMI 五分位数之间存在显著差异。具体来说,最低 FFMI 五分位数(Q1,10.4-16.0,代表 FFMI 值范围)的患者全因死亡风险显著增加(HR:4.63;95% CI:1.59, 13.5;P 结论:该研究表明,高 FFMI 和 FFMI 五分位数患者的全因死亡风险均显著增加:研究表明,高 FMI 和低 FFMI 都与哮喘患者死亡率的增加有关。这些发现强调了 FMI 和 FFMI 在哮喘患者健康管理中的关键作用。因此,建议临床医生积极监测和调整这些指数,以改善患者的预后,提高哮喘患者的健康状况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Variation of All-Cause Mortality with Fat-Free Mass Index (FFMI) and Fat Mass Index (FMI) in Individuals with Asthma: Results from the NHANES Database Retrospective Cohort Study.

Background: The relationship between fat-free mass index (FFMI), fat mass index (FMI), and mortality in patients with asthma remains unknown. This study aimed to examine the associations between FFMI and FMI and all-cause mortality in a cohort of American adults diagnosed with asthma.

Methods: This study included 15,200 adults from NHANES. To assess mortality, we linked participant records to the National Death Index. FMI and FFMI were measured and evaluated using dual-energy X-ray absorptiometry (DXA). Survival differences across quintiles of FFMI and FMI were explored using Kaplan-Meier plots and log-rank tests, with the proportional hazards assumption assessed using Schoenfeld residuals. Cox proportional hazards regression models were used to estimate the hazard ratios (HRs) for mortality associated with FFMI and FMI, adjusting for potential confounders including age, sex, smoking status, physical activity, and other relevant factors. Additionally, stratified analyses based on theoretical considerations were conducted to identify subgroups of individuals exhibiting an elevated risk of mortality. This study also examined the nonlinear relationships between FFMI, FMI, and mortality using restricted cubic splines (RCS).

Results: After a median follow-up of 184 months, 12.11% of individuals had died. Kaplan-Meier plots revealed significant differences in all-cause mortality among patients with asthma across the FFMI and FMI quintiles. Specifically, individuals in the lowest FFMI quintile (Q1, 10.4-16.0, representing the range of FFMI values) exhibited a significantly increased risk of all-cause mortality (HR: 4.63; 95% CI: 1.59, 13.5; p < 0.01). Similarly, elevated risks of all-cause mortality were observed in the upper three quintiles of FMI, with Q3 (4.8-6.1) having an HR of 2.9 (95% CI: 1.20, 7.00; p < 0.05), Q4 (6.2-8.3) having an HR of 3.37 (95% CI: 1.41, 8.03; p < 0.01), and Q5 (8.4-22.8) having an HR of 4.6 (95% CI: 1.31, 16.2; p < 0.05). Moreover, the risk of all-cause mortality increased with increasing FMI and decreasing FFMI (p for non-linearity < 0.001 in both cases). Subgroup analyses further elucidated these associations across different categories. In examining the association between FMI and all-cause mortality among asthma patients across various subgroups, a heightened mortality risk found among males, individuals with medium education levels, medium income levels, and those who consume alcohol.

Conclusions: The study shows that both high FMI and low FFMI are associated with increased mortality in patients with asthma. These findings underscore the critical role of FMI and FFMI in the health management of asthma patients. Therefore, it is recommended that clinicians proactively monitor and adjust these indices to improve patient prognosis and enhance health outcomes for individuals with asthma..

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来源期刊
CiteScore
10.70
自引率
1.40%
发文量
57
审稿时长
19 weeks
期刊介绍: The Journal of Epidemiology and Global Health is an esteemed international publication, offering a platform for peer-reviewed articles that drive advancements in global epidemiology and international health. Our mission is to shape global health policy by showcasing cutting-edge scholarship and innovative strategies.
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