BMI与慢性阻塞性肺病患者死亡率相关性的Meta分析  

Body mass index and mortality of chronic obstructive pulmonary disease: a meta-analysis

作　　者：朱洁云 罗毅沣[1] 王霄玲 钟枝梅 李倩 李柏成 张剑锋[1] ZHU Jieyun;LUO Yifeng;WANG Xiaoling;ZHONG Zhimei;LI Qian;LI Bocheng;ZHANG Jianfeng(Department of Emergency,The Second Affiliated Hospital ofGuangxi Medical University,Nanning,530007,P.R.China)

机构地区：[1]广西医科大学第二附属医院急诊科

出　　处：《中国循证医学杂志》2019年第7期811-817,共7页Chinese Journal of Evidence-based Medicine

基　　金：广西重点研发项目(编号:桂科AB17195002);广西高等教育本科教学改革工程立项项目(编号:2017JGA159)

摘　　要：目的系统评价体重指数(BMI)与慢性阻塞性肺病(COPD)死亡率的相关性。方法计算机检索PubMed、The Cochrane Library、EMbase、WanFang Data、CNKI和VIP数据库,搜集BMI与COPD死亡率相关的队列研究,检索时限均从建库至2019年2月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入14个队列研究,共计494 060例COPD患者。Meta分析结果显示:与正常体重患者相比,低体重COPD患者的死亡率更高[RR=1.40,95%CI(1.15,1.71),P=0.000 8],超重[RR=0.65,95%CI(0.54,0.79),P<0.000 1]和肥胖[RR=0.37,95%CI(0.20,0.67),P=0.001]COPD患者的死亡率更低,差异均有统计学意义。结论当前证据表明,低体重COPD患者的全因死亡率较高,超重或肥胖COPD患者的全因死亡率较低。受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。Objectives To systematically review the association between body mass index(BMI) and mortality of chronic obstructive pulmonary disease(COPD). Methods PubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect cohort studies on the association between BMI and mortality of COPD from inception to February, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software. Results A total of 14 cohort studies involving 494 060 COPD patients were included. The results of meta-analysis showed that,compared with patients having a normal weight, underweight individuals were associated with higher mortality(RR=1.40,95%CI 1.15 to 1.71, P=0.000 8), whereas overweight(RR=0.65, 95%CI 0.54 to 0.79, P<0.000 1) and obese(RR=0.37, 95%CI0.20 to 0.67, P=0.001) patients were associated with lower mortality. Conclusions Current evidence shows that underweight is associated with a higher risk of all-cause mortality among patients with COPD, whereas overweight and obese are associated with lower risk of all-cause mortality in these patients. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.

关 键 词：体重指数 慢性阻塞性肺疾病 死亡率 META分析 系统评价 队列研究 

分 类 号：R563.9[医药卫生—呼吸系统]