比较慢性阻塞性肺疾病的异质性表型:网络分析和惩罚广义线性模型。

IF 2.7 3区 医学 Q2 RESPIRATORY SYSTEM
Hyeon-Kyoung Koo, Sung Jun Chung, Dongil Park, Ho Cheol Kim, Hyewon Seo, Hyun Jung Kim, Hyoung Kyu Yoon, Chin Kook Rhee, Kwang Ha Yoo, Deog Kyeom Kim
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引用次数: 0

摘要

背景和目的:慢性阻塞性肺疾病(COPD)是一种异质性疾病,具有慢性支气管炎(CB)和肺气肿表型。我们研究的目的是比较呼吸系统症状和不同COPD表型未来恶化预测因子的不同相关网络模式。方法:分别通过问卷调查和计算机断层扫描图像识别CB和肺气肿,并纳入保留比例肺功能受损(PRISm)患者。我们使用Spearman相关系数为每个子组构建单独的相关网络。在多变量分析中,通过最小绝对收缩和选择操作回归分析选择未来恶化的预测因子。结果:3436例患者中,非CB组2232例,CB组1131例,肺气肿组1116例,PRISm组73例。一秒用力呼气量(FEV1)和呼吸症状的恶化顺序为:PRISm组、非CB组、肺气肿组和CB组。在1年的随访中,非肺气肿组、肺气肿组和肺气肿组分别有17.3%、21.3%和18.9%的患者出现加重。每一组在人口统计学特征、合并症、肺功能、血液生物标志物、呼吸系统症状和运动能力之间都显示出明显的相关模式。在所有组中,较低的FEV1(%)、较高的白细胞计数、较高的红细胞沉降率、较差的圣乔治呼吸问卷症状和总分被确定为未来恶化的常见危险因素。然而,每一组都显示出不同的未来恶化预测因子。结论:COPD表型不同,其相关网络模式和未来加重的预测因子存在显著差异。需要进一步的研究来了解COPD的异质性病理生理,促进个体化治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparing Heterogenous Phenotypes of Chronic Obstructive Pulmonary Disease: Network Analysis and Penalized Generalized Linear Model.

Background and objective: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease, with chronic bronchitis (CB) and emphysema phenotypes. The aim of our study was to compare the distinct patterns of correlation networks for respiratory symptoms and predictors of future exacerbations of different COPD phenotypes.

Methods: CB and emphysema were identified using a questionnaire and computed tomography images, respectively, and also included patients with preserved ratio impaired spirometry (PRISm). We constructed separate correlation networks for each subgroup using Spearman correlation coefficients. Predictors of future exacerbations were selected via least absolute shrinkage and selection operation regression analyses in multivariable analysis.

Results: Among the 3436 patients, 2232 were non-CB, 1131 were CB, 1116 were emphysema, and 73 were PRISm groups. The forced expiratory volume in one second (FEV1) and respiratory symptoms worsened in the following order: PRISm, non-CB, emphysema, and CB groups. During the 1-year follow-up, 17.3%, 21.3%, and 18.9% of patients in the non-CB, CB, and emphysema groups, respectively, experienced exacerbation. Each group showed a distinct correlation pattern between demographic characteristics, comorbidities, pulmonary function, blood biomarkers, respiratory symptoms, and exercise capacity. Across all groups, lower FEV1 (%), higher white blood cell count, higher erythrocyte sedimentation rate, and worse Saint George's Respiratory Questionnaire symptom and total scores were identified as common risk factors for future exacerbations. However, each group showed distinct predictors for future exacerbations.

Conclusion: The correlation network patterns and predictors of future exacerbations varied significantly depending on the COPD phenotype. Further research is required to understand the heterogeneous COPD pathophysiology and facilitate personalized medicine.

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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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