PDF(Pubmed)
Abstract：
UNASSIGNED: Sarcopenia frequently occurs as a comorbidity in individuals with COPD. However, research on the impact of Appendicular Skeletal Muscle Mass (ASM) on survival in COPD patients is scarce. Moreover, there is a lack of research on the association between dietary pro-inflammatory capacity and sarcopenia in COPD.
UNASSIGNED: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) covering the years 1999 to 2006 and 2011 to 2018. We aimed to investigate the relationship between the Dietary Inflammatory Index (DII) and sarcopenia prevalence among adults diagnosed with COPD in the United States. Furthermore, we sought to explore the relationship between sarcopenia, ASMI, and all-cause mortality. The study included a total of 1,429 eligible adult participants, divided into four groups based on quartiles of DII, with adjustments for sample weights. Methodologically, we used multivariable logistic regression analyses and to examine the association between DII and sarcopenia. Additionally, we used restricted cubic spline (RCS) tests to evaluate potential non-linear relationships. To assess the effect of sarcopenia on overall all-cause mortality, we used Kaplan-Meier models and Cox proportional hazards models. Moreover, we used RCS analyses to investigate potential non-linear relationships between ASMI and all-cause mortality. Subgroup analyses were conducted to confirm the reliability of our study findings.
UNASSIGNED: In our COPD participant cohort, individuals with higher DII scores were more likely to be female, unmarried, have lower educational attainment, and show lower ASMI. Using multivariable logistic regression models, we found a positive association between the highest quartile of DII levels and sarcopenia incidence [Odds Ratio (OR) 2.37; 95% Confidence Interval (CI) 1.26-4.48; p = 0.01]. However, analysis of RCS curves did not show a non-linear relationship between DII and sarcopenia. Throughout the entire follow-up period, a total of 367 deaths occurred among all COPD patients. Kaplan-Meier survival curves showed a significantly higher all-cause mortality rate among individuals with concurrent sarcopenia (p < 0.0001). Cox proportional hazards model analysis showed a 44% higher risk of all-cause mortality among COPD patients with sarcopenia compared to those without sarcopenia [Hazard Ratio (HR): 1.44; 95% CI 1.05-1.99; p < 0.05]. Additionally, our final RCS analyses revealed a significant non-linear association between ASMI levels and all-cause mortality among COPD patients, with a turning point identified at 8.32 kg/m2. Participants with ASMI levels above this inflection point had a 42% lower risk of all-cause mortality compared to those with ASMI levels below it (HR 0.58; 95% CI 0.48-0.7).
UNASSIGNED: We observed a significant association between concurrent sarcopenia and an increased risk of all-cause mortality in COPD patients within the United States. Moreover, ASMI demonstrated a non-linear association with all-cause mortality, with a critical threshold identified at 8.32 kg/m2. Our findings also revealed an association between DII and the presence of sarcopenia. Consequently, further investigations are warranted to explore the feasibility of dietary DII adjustments as a means to mitigate muscle wasting and enhance the prognosis of COPD.
UNASSIGNED: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) covering the years 1999 to 2006 and 2011 to 2018. We aimed to investigate the relationship between the Dietary Inflammatory Index (DII) and sarcopenia prevalence among adults diagnosed with COPD in the United States. Furthermore, we sought to explore the relationship between sarcopenia, ASMI, and all-cause mortality. The study included a total of 1,429 eligible adult participants, divided into four groups based on quartiles of DII, with adjustments for sample weights. Methodologically, we used multivariable logistic regression analyses and to examine the association between DII and sarcopenia. Additionally, we used restricted cubic spline (RCS) tests to evaluate potential non-linear relationships. To assess the effect of sarcopenia on overall all-cause mortality, we used Kaplan-Meier models and Cox proportional hazards models. Moreover, we used RCS analyses to investigate potential non-linear relationships between ASMI and all-cause mortality. Subgroup analyses were conducted to confirm the reliability of our study findings.
UNASSIGNED: In our COPD participant cohort, individuals with higher DII scores were more likely to be female, unmarried, have lower educational attainment, and show lower ASMI. Using multivariable logistic regression models, we found a positive association between the highest quartile of DII levels and sarcopenia incidence [Odds Ratio (OR) 2.37; 95% Confidence Interval (CI) 1.26-4.48; p = 0.01]. However, analysis of RCS curves did not show a non-linear relationship between DII and sarcopenia. Throughout the entire follow-up period, a total of 367 deaths occurred among all COPD patients. Kaplan-Meier survival curves showed a significantly higher all-cause mortality rate among individuals with concurrent sarcopenia (p < 0.0001). Cox proportional hazards model analysis showed a 44% higher risk of all-cause mortality among COPD patients with sarcopenia compared to those without sarcopenia [Hazard Ratio (HR): 1.44; 95% CI 1.05-1.99; p < 0.05]. Additionally, our final RCS analyses revealed a significant non-linear association between ASMI levels and all-cause mortality among COPD patients, with a turning point identified at 8.32 kg/m2. Participants with ASMI levels above this inflection point had a 42% lower risk of all-cause mortality compared to those with ASMI levels below it (HR 0.58; 95% CI 0.48-0.7).
UNASSIGNED: We observed a significant association between concurrent sarcopenia and an increased risk of all-cause mortality in COPD patients within the United States. Moreover, ASMI demonstrated a non-linear association with all-cause mortality, with a critical threshold identified at 8.32 kg/m2. Our findings also revealed an association between DII and the presence of sarcopenia. Consequently, further investigations are warranted to explore the feasibility of dietary DII adjustments as a means to mitigate muscle wasting and enhance the prognosis of COPD.
摘要：
■肌肉减少症经常作为COPD患者的合并症发生。然而,关于阑尾骨骼肌质量(ASM)对COPD患者生存影响的研究很少.此外，缺乏关于COPD患者饮食促炎能力与肌肉减少症之间关系的研究.
■我们分析了1999年至2006年以及2011年至2018年的国家健康与营养检查调查（NHANES）的数据。我们的目的是调查在美国诊断为COPD的成年人中饮食炎症指数（DII）与肌肉减少症患病率之间的关系。此外，我们试图探索肌少症之间的关系，ASMI,和全因死亡率。该研究共包括1,429名合格的成年参与者，根据DII的四分位数分为四组，对样本权重进行调整。方法上,我们采用多变量logistic回归分析,以检验DII与肌肉减少症之间的相关性.此外,我们使用受限三次样条（RCS）检验来评估潜在的非线性关系。为了评估肌少症对总全因死亡率的影响，我们使用Kaplan-Meier模型和Cox比例风险模型.此外，我们使用RCS分析来调查ASMI与全因死亡率之间的潜在非线性关系.进行亚组分析以证实我们研究结果的可靠性。
■在我们的COPD参与者队列中，DII分数较高的个体更有可能是女性，未婚,受教育程度较低，并显示较低的ASMI。使用多变量逻辑回归模型，我们发现最高四分位数的DII水平与肌肉减少症发病率之间存在正相关[几率比(OR)2.37;95%置信区间(CI)1.26~4.48;p=0.01].然而,RCS曲线分析未显示DII与肌肉减少症之间存在非线性关系.在整个随访期间，所有COPD患者共发生367例死亡.Kaplan-Meier存活曲线显示，并发肌少症患者的全因死亡率显著增高（p<0.0001）。Cox比例风险模型分析显示，与无肌肉减少症的COPD患者相比，有肌肉减少症的患者全因死亡风险高44%[危险比（HR）：1.44；95%CI1.05-1.99；p<0.05]。此外,我们最终的RCS分析显示,COPD患者的ASMI水平与全因死亡率之间存在显著的非线性关联,转折点为8.32kg/m2。与ASMI水平低于该拐点的参与者相比，ASMI水平高于该拐点的参与者的全因死亡率风险降低了42％（HR0.58；95％CI0.48-0.7）。
■我们观察到在美国的COPD患者并发肌少症与全因死亡风险增加之间存在显著关联。此外，ASMI与全因死亡率呈非线性关系,临界阈值为8.32kg/m2。我们的发现还揭示了DII与肌少症的存在之间的关联。因此,有必要进行进一步的研究,以探讨膳食DII调整作为减轻COPD肌肉萎缩和改善COPD预后的手段的可行性.
■我们分析了1999年至2006年以及2011年至2018年的国家健康与营养检查调查（NHANES）的数据。我们的目的是调查在美国诊断为COPD的成年人中饮食炎症指数（DII）与肌肉减少症患病率之间的关系。此外，我们试图探索肌少症之间的关系，ASMI,和全因死亡率。该研究共包括1,429名合格的成年参与者，根据DII的四分位数分为四组，对样本权重进行调整。方法上,我们采用多变量logistic回归分析,以检验DII与肌肉减少症之间的相关性.此外,我们使用受限三次样条（RCS）检验来评估潜在的非线性关系。为了评估肌少症对总全因死亡率的影响，我们使用Kaplan-Meier模型和Cox比例风险模型.此外，我们使用RCS分析来调查ASMI与全因死亡率之间的潜在非线性关系.进行亚组分析以证实我们研究结果的可靠性。
■在我们的COPD参与者队列中，DII分数较高的个体更有可能是女性，未婚,受教育程度较低，并显示较低的ASMI。使用多变量逻辑回归模型，我们发现最高四分位数的DII水平与肌肉减少症发病率之间存在正相关[几率比(OR)2.37;95%置信区间(CI)1.26~4.48;p=0.01].然而,RCS曲线分析未显示DII与肌肉减少症之间存在非线性关系.在整个随访期间，所有COPD患者共发生367例死亡.Kaplan-Meier存活曲线显示，并发肌少症患者的全因死亡率显著增高（p<0.0001）。Cox比例风险模型分析显示，与无肌肉减少症的COPD患者相比，有肌肉减少症的患者全因死亡风险高44%[危险比（HR）：1.44；95%CI1.05-1.99；p<0.05]。此外,我们最终的RCS分析显示,COPD患者的ASMI水平与全因死亡率之间存在显著的非线性关联,转折点为8.32kg/m2。与ASMI水平低于该拐点的参与者相比，ASMI水平高于该拐点的参与者的全因死亡率风险降低了42％（HR0.58；95％CI0.48-0.7）。
■我们观察到在美国的COPD患者并发肌少症与全因死亡风险增加之间存在显著关联。此外，ASMI与全因死亡率呈非线性关系,临界阈值为8.32kg/m2。我们的发现还揭示了DII与肌少症的存在之间的关联。因此,有必要进行进一步的研究,以探讨膳食DII调整作为减轻COPD肌肉萎缩和改善COPD预后的手段的可行性.
