江苏省中老年人群体质指数与慢性阻塞性肺疾病关联研究  

Study on the relationship between body mass index and chronic obstructive pulmonary disease in middle-aged and elderly people in Jiangsu Province

作　　者：宛星霖 陈路路 苏健[2] 万亚男 罗鹏飞[2] 杜文聪[2] 朱政[2] 陶然 周金意[1,2] WAN Xing-lin;CHEN Lu-lu;SU Jian;WAN Ya-nan;LUO Peng-fei;DU Wen-cong;ZHU Zheng;TAO Ran;ZHOU Jin-yi(Department of Epidemiology and Health Statistics,School of Public Health,Nanjing Medical University,Nanjing,Jiangsu 211166,China;不详)

机构地区：[1]南京医科大学公共卫生学院流行病与卫生统计学系,江苏南京211166 [2]江苏省疾病预防控制中心慢性非传染性疾病防制所,江苏南京210009

出　　处：《现代预防医学》2023年第21期4027-4032,共6页Modern Preventive Medicine

摘　　要：目的分析江苏省中老年人群体质指数(body mass index,BMI)与慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患病间的关联以及潜在的交互作用,为制定COPD防控策略和措施提供理论依据。方法2015年7—12月,采用多阶段整群随机抽样的方法抽取江苏省6个市(区)共3600名≥40岁常住居民为研究对象,进行问卷调查、体格检查以及肺功能检测。采用R 3.5.3软件进行方差分析、χ^(2)检验、多因素线性回归分析和多因素logistic回归分析。结果最终3365名研究对象纳入数据分析,其中COPD患者428名(12.7%)。低体重者38人(1.1%),体重正常者1257人(37.4%),超重者1480人(44.0%),肥胖者590人(17.5%)。多因素线性回归分析结果显示,使用支气管扩张剂后的FEV1/FVC水平随BMI增加而上升(β=0.30);与体重正常的人群相比,超重及肥胖的人群支扩后的FEV1/FVC水平更高(β=1.14,2.14),均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,BMI与COPD患病呈负相关(OR=0.89,95%CI:0.84~0.95);与体重正常的人群相比,低体重与COPD患病增加相关(OR=3.14,95%CI:1.38~7.17),肥胖与COPD患病降低相关(OR=0.46,95%CI:0.28~0.75),均有统计学意义(P<0.05)。此外,在男性(P交互<0.001)、当前吸烟者(P交互<0.001)以及暴露于生物燃料者(P交互=0.009)中观察到BMI与FEV1/FVC间具有更强的关联强度。结论江苏省中老年人群BMI与支气管扩张后的FEV1/FVC呈正相关,与COPD患病呈负相关,提示适宜的体重增长或许能够改善肺功能。Objective To analyze the correlation and potential interaction between body mass index(BMI)and chronic obstructive pulmonary disease(COPD)in middle-aged and elderly people in Jiangsu Province,to provide theoretical basis for formulating prevention and control strategies and measures of COPD.Methods By using the method of multi-stage cluster random sampling,3600 permanent residents≥40 years old in 6 cities(districts)of Jiangsu Province were selected for questionnaire survey,physical examination,and lung function test from July to December 2015.R3.5.3 software was used for analysis of variance,Chi-square test,multi-factor linear regression analysis,and multi-factor logistic regression analysis.Results In total 3365 participants were enrolled,including 428 COPD patients(12.7%),of which 38(1.1%)were underweight,1257(37.4%)were normal weight,1480(44.0%)were overweight,and 590(17.5%)were obese.The results of multivariate linear regression analysis showed that the level of FEV1/FVC increased with the increase of BMI after using bronchodilator(β=0.3),and the FEV1/FVC level of overweight and obese people after bronchodilation was higher than that of normal weight people(β=1.14 and 2.14,respectively).The results of multivariate logistic regression analysis showed that there was a negative correlation(P<0.001)between BMI and the prevalence of COPD(OR=0.89,95%CI:0.84-0.95),and there was a significant correlation between low body weight and increased prevalence of COPD(OR=3.14,95%CI:1.38-7.17),obesity and decreased prevalence of COPD(OR=0.46,95%CI:0.28-0.75)compared with those with normal weight(P=0.006,P=0.002).In addition,a stronger correlation between BMI and FEV1/FVC was observed in men(Pinteraction<0.001),current smokers(P interaction<0.001),and biofuel exposure(Pinteraction=0.009).Conclusion BMI is positively correlated with FEV1/FVC after bronchiectasis and negatively correlated with COPD in middle-aged and elderly people in Jiangsu Province,suggesting that appropriate weight gain may improve lung function.

关 键 词：体质指数 慢性阻塞性肺疾病 肺功能 交互作用 中老年人 

分 类 号：R563[医药卫生—呼吸系统]