基于美国国家健康和营养检查调查数据库分析代谢风险因素与老年慢性阻塞性肺疾病的关系OA
Analysis of relationship between metabolic risk factors and chronic obstructive pulmonary disease in the elderly based on National Health and Nutrition Examination Survey database of the United States
目的 探究高密度脂蛋白胆固醇(HDL-C)、体重指数(BMI)和身体圆度指数(BRI)与老年慢性阻塞性肺疾病(COPD)的关系.方法 回顾性研究2013 年至2023 年美国国家健康和营养检查调查数据库中年龄≥60 岁的5 915 名参与者,根据是否患有 COPD 进行分组.多变量 Logistic 回归模型、亚组分析和限制性立方样条曲线分析探索 HDL-C、BMI和 BRI 水平对老年 COPD 风险的影响.结果 非 COPD 组中的 HDL-C 水平显著高于 COPD 组(1.44 比1.40 mmol/L),但 BMI 和 BRI 显著低于 COPD 组(分别为29.27 比 30.30 kg/m2,6.10 比 6.83,P 均<0.05).高水平的 HDL-C(最高四分位数)与老年 COPD 的发生呈显著负相关[优势比=0.665(0.465～0.952),P=0.032],而高水平的 BMI(最高四分位数)[优势比=1.447(1.067～1.961),P=0.023]和 BRI(最高四分位数)呈显著正相关[优势比=2.291(1.761～2.980),P<0.001].在高 BMI(最高四分位数)和 BRI(最高四分位数)的群体中,较高的 HDL-C 可能会降低老年 COPD的风险,并且 BMI 与 HDL-C 水平对老年 COPD 的影响存在明显的交互作用(P=0.040),而 BRI 不显著(P=0.133).HDL-C 与老年 COPD 存在显著非线性关系(P<0.001).BMI 和 BRI 与老年 COPD 具有显著线性关系(BMI:总趋势 P=0.025,BRI:总趋势 P<0.001).结论 高 HDL-C 可能会降低老年 COPD 风险,而高 BMI 和高 BRI 可能会增加老年COPD 风险.
Objective To investigate the relationship between high-density lipoprotein cholesterol(HDL-C),body mass index(BMI),and body roundness index(BRI)with chronic obstructive pulmonary disease(COPD)in the elderly.Methods A retrospective study was conducted on 5 915 participants aged 60 and above from the National Health and Nutrition Examination Survey database of the United States from 2013 to 2023.They were grouped according to whether they had COPD or not.Multivariate logistic regression models,subgroup analyses,and restricted cubic spline curve analyses were used to explore the effects of the levels of HDL-C,BMI and BRI on the risk of COPD in the elderly.Results The HDL-C level in the non-COPD group was significantly higher than that in the COPD group(1.44 vs.1.40 mmol/L),but the levels of BMI(29.27 vs.30.30 kg/m2)and BRI(6.10 vs.6.83)in the non-COPD group were significantly lower(P<0.05).High HDL-C(the highest quartile)was significantly negatively associated with the occurrence of COPD in the elderly[odds ratio=0.665(0.465--0.952),P=0.032],while high BMI(the highest quartile)[odds ratio=1.447(1.067--1.961),P=0.023]and BRI(the highest quartile)[odds ratio=2.291(1.761--2.980),P<0.001]were significantly positively associated the occurrence of COPD in the elderly.Higher HDL-C in those with high BMI(the highest quartile)and BRI(the highest quartile)might reduce the risk of COPD.There was a significant interaction between BMI and HDL-C levels in their effects on COPD in the elderly(P=0.040),while the interaction with BRI was not significant(P=0.133).There was a significant non-linear relationship between HDL-C and COPD in the elderly(P<0.001).BMI and BRI had significant linear relationships with COPD in the elderly(BMI:overall trend P=0.025;BRI:overall trend P<0.001).Conclusion High HDL-C may reduce the risk of COPD in the elderly,while high BMI and BRI may increase the risk of COPD in the elderly.
蔡凯愉;冯雯卿;盛华
上海交通大学医学院附属瑞金医院全科医学科,上海 200025上海交通大学医学院附属瑞金医院全科医学科,上海 200025复旦大学附属华东医院呼吸与危重症医学科,上海 200040
老年肺疾病,慢性阻塞性胆固醇,高密度体重指数身体圆度指数美国国家健康和营养检查调查数据库
elderlypulmonary disease,chronic obstructivecholesterol,HDLbody mass indexbody roundness indexNHANES database
《老年医学与保健》 2026 (2)
207-217,11
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