中国成年人慢性阻塞性肺疾病与骨密度的相关性分析  

The relationship between chronic obstructive pulmonary disease and bone mineral density in Chinese adults

作　　者：史可香 朱蕴卿 余灿清[1,2] 吕筠[1,2] 郭彧 裴培 杨玲[4,5] 杜怀东[4,5] 陈怡平[4,5] 陈君石 陈铮鸣[5] 李立明[1,2] 中国慢性病前瞻性研究项目协作组 Shi Kexiang;Zhu Yunqing;Yu Canqing;Lyu Jun;Guo Yu;Pei Pei;Yang Ling;Du Huaidong;Chen Yiping;Chen Junshi;Chen Zhengming;Li Liming(Department of Epidemiology and Biostatistics,School of Public Health,Peking University,Beijing 100191,China;Peking University Center for Public Health and Epidemic Preparedness&Response,Beijing 100191,China;Fuwai Hospital,Chinese Academy of Medical Sciences,National Center for Cardiovascular Diseases,Beijing 100037,China;Medical Research Council Population Health Research Unit at the University of Oxford,Oxford Population Health,Oxford OX37LF,United Kingdom;Clinical Trial Service Unit and Epidemiological Studies Unit,Nuffield Department of Population Health,University of Oxford,Oxford OX37LF,United Kingdom;China National Center for Food Safety Risk Assessment,Beijing 100022,China)

机构地区：[1]北京大学公共卫生学院流行病与卫生统计学系,北京100191 [2]北京大学公众健康与重大疫情防控战略研究中心,北京100191 [3]中国医学科学院阜外医院/国家心血管病中心,北京100037 [4]英国牛津大学医学研究委员会人口健康研究组,牛津OX37LF [5]英国牛津大学临床与流行病学研究中心纳菲尔德人群健康系,牛津OX37LF [6]国家食品安全风险评估中心,北京100022 [7]不详

出　　处：《中华流行病学杂志》2023年第2期221-228,共8页Chinese Journal of Epidemiology

基　　金：国家自然科学基金(81941018,91846303);国家重点研发计划(2016YFC0900500,2016YFC1303904);中国香港Kadoorie Charitable基金。

摘　　要：目的探究我国成年男性和女性中慢性阻塞性肺疾病(COPD)与骨密度的关系。方法利用中国慢性病前瞻性研究第二次重复调查的数据,采用线性回归分析COPD及慢性阻塞性肺疾病全球倡议(GOLD)分级与跟骨骨密度指标(宽带超声衰减、超声声速、强度指数)之间的相关性。结果共纳入23876名研究对象,男性COPD患病率为34.3%(3130/9125),女性COPD患病率为23.2%(3416/14751)。以健康男、女性为参照,男、女性COPD患者的宽带超声衰减、超声声速、强度指数均降低,男性对应的β值(95%CI)分别为-0.87(-1.37~-0.36)、-3.42(-5.42~-1.43)、-1.53(-2.34~-0.71),女性对应的β值(95%CI)分别为-0.66(-1.09~-0.23)、-2.24(-3.92~-0.55)、-1.06(-1.71~-0.40),男性中下降幅度更大(交互作用均P<0.05)。GOLD分级与宽带超声衰减、超声声速、强度指数呈负相关,且存在线性趋势(线性趋势检验均P<0.001)。亚组分析显示,男性年龄≥60岁、男性低体力活动水平者、男、女性非超重/肥胖者中COPD患者骨密度下降幅度更大。结论COPD与骨密度呈负相关,应加强对COPD患者骨密度的关注,尤其应关注年龄大、体力活动水平低、非超重/肥胖的COPD患者。Objective To investigate the relationship between chronic obstructive pulmonary disease(COPD)and bone mineral density(BMD)in Chinese male and female adults.Methods Linear regression models were used to analyze the correlations between COPD and the Global Initiative for Chronic Obstructive Lung Disease(GOLD)grade concerning bone mineral density indices,including broadband ultrasound attenuation,speed of sound,and stiffness index,based on data from the second resurvey of China Kadoorie Biobank.Results Among 23876 participants,the prevalence of COPD was 34.3%(3130/9125)in males and 23.2%(3416/14751)in females.Compared with healthy males and healthy females,broadband ultrasound attenuation,speed of sound,and stiffness index decreased in males and females with COPD,withβvalues(95%CI)of-0.87(-1.37--0.36),-3.42(-5.42--1.43)and-1.53(-2.34--0.71)in males and-0.66(-1.09--0.23),-2.24(-3.92--0.55),-1.06(-1.71--0.40)in females,respectively.The decrease was greater in males than females(all P for interaction<0.05).The GOLD grade of COPD was inversely correlated with all the three indices in a dose-response manner(all P for trend<0.001).Subgroup analysis showed that patients with COPD had a greater decrease in BMD in males whose ages were≥60 years,males who were less physically active,and participants who were not overweight or obese.Conclusions COPD was negatively correlated with bone mineral density.More attention should be paid to the bone mineral density of patients with COPD,especially those with older age,less physical activity,or lower BMI.

关 键 词：慢性阻塞性肺疾病 慢性阻塞性肺疾病全球倡议分级 骨密度 

分 类 号：R563.9[医药卫生—呼吸系统]