■身体成分变化是慢性阻塞性肺疾病(COPD)患者重要的肺外表现。本研究旨在探讨COPD患者身体成分的特点,及其与疾病严重程度的相关性。
■大连大学附属中山医院收治的COPD患者共105人,从2021年5月1日至2023年1月31日,被列为COPD组,同期纳入105名非COPD受试者作为对照组。根据全球慢性阻塞性肺疾病倡议(GOLD)综合评估指标,COPD患者分为:肺功能气流受限程度按FEV1%pred分组;临床症状按mMRC评分和CAT评分分组;急性加重风险分为低危和高危。通过生物电阻抗分析(BIA)测量身体成分。
■(1)关于身体成分,体重指数(BMI),无脂质量指数(FFMI),COPD患者的相位角(PhA)低于对照组。细胞外水与全身水的比值(ECW/TBW)和细胞外水的比值(ECW/ICW)均高于对照组,差异有统计学意义(p<0.05)。(2)不同病情严重程度的COPD患者体成分存在差异:轻度/中度气流受限组的FFMI和PhA高于重度/极重度气流受限组。根据mMRC分数分类,症状较轻的组的FFMI和PhA高于症状较重的组,ECW/TBW和ECW/ICW均低于症状加重组。根据CAT成绩分类,轻度/中度疾病组的FFMI和PhA高于重度/极重度疾病组。低危组的FFMI高于高危组。ECW/TBW低于高危组。(3)身体成分与疾病严重程度指标的相关性分析显示,FFMI和PhA与mMRC评分和CAT评分呈负相关,与FEV1%pred呈正相关。ECW/TBW比值和ECW/ICW比值与mMRC评分和CAT评分呈正相关,与FEV1%pred呈负相关,差异有统计学意义(p<0.05)。
■COPD患者的身体成分与对照组之间存在显着差异,不同严重程度的COPD患者身体成分存在显著差异,身体成分和疾病严重程度之间的相关性。
UNASSIGNED: Body composition changes are important extrapulmonary manifestations in chronic obstructive pulmonary disease (COPD) patients. This study aimed to investigate the characteristics of body composition in patients with COPD, and its correlation with disease severity.
UNASSIGNED: A total of 105 COPD patients admitted to Zhongshan Hospital affiliated to Dalian University, from May 1, 2021 to January 31, 2023, were included as the COPD group, and 105 subjects without COPD were enrolled as the control group during the same period. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) comprehensive assessment indicators, COPD patients were divided into groups: the degree of pulmonary function airflow limitation was grouped according to FEV1%pred; clinical symptoms were grouped according to mMRC scores and CAT scores; the risk of acute exacerbation was divided into low risk and high risk groups. Body composition was measured by bioelectrical impedance analysis (BIA).
UNASSIGNED: (1) Concerning body composition, the body mass index (BMI), fat-free mass index (FFMI), and angle of phase (PhA) of COPD patients were lower than those of the control group. Extracellular water-to-total body water ratio (ECW/TBW) and extra-to-intracellular water ratio (ECW/ICW) were higher than those of the control group, and the difference was statistically significant (p < 0.05). (2) There were differences in body composition among COPD patients with different severity of disease: FFMI and PhA in the mild/moderate airflow limitation group were higher than those in the severe/very severe airflow limitation group. According to mMRC scores classification, the FFMI and PhA of the less symptomatic group were higher than those of the more symptomatic group, and ECW/TBW and ECW/ICW were lower than those of the more symptomatic group. According to CAT scores classification, FFMI and PhA in the mild/moderate disease group were higher than those in the severe/very severe disease group. The FFMI of the low-risk group was higher than that of the high-risk group, and ECW/TBW was lower than that of the high risk group. (3) Correlation analysis between body composition and disease severity indicators showed that FFMI and PhA were negatively correlated with mMRC scores and CAT scores, and positively correlated with FEV1%pred. ECW/TBW ratio and ECW/ICW ratio were positively correlated with mMRC scores and CAT scores, and negatively correlated with FEV1%pred, and the difference was statistically significant (p < 0.05).
UNASSIGNED: There are significant differences in body composition between COPD patients and the control group, and there are significant differences in body composition between COPD patients with different severity of disease, with correlations between body composition and severity of disease.