Abstract：Objective To investigate the effect of intermuscular fat content in soleus on the mortality rate of patients with chronic obstructive pulmonary disease (COPD). Methods One hundred and twelve non-hospitalized COPD patients diagnosed in the First Affiliated Hospital of Hebei North University from January 2014 to March 2015 were collected. Ntermuscular fat content, body mass index (BMI) and other relevant clinical data were collected and followed up by telephone for 3 years. Cox proportional hazard regression model was used to evaluate the relationship between all-cause mortality and BMI, intermuscular fat content of soleus muscle and other factors. Results A total of 21 patients died during the follow-up period, with older age and longer course of disease, COPD global initiative interpretation(GOLD) grade and intermuscular fat content in soleus muscle, and lower BMI and forced expiratory volume at 1 second (FEV1), and more patients with comorbidities, less patients receiving long-term home oxygen therapy. BMI ＜ 21 kg/m2 was a risk factor for high mortality among patients with COPD in risk model Ⅰ(HR = 2.97, P = 0.02); the soleus muscle fat content ＞ 12% was a risk factor for high mortality among patients with COPD in risk model Ⅱ(HR = 2.17, P = 0.0014). - 2 times of the logarithmic likelihood function value of risk model Ⅱ was lower than the risk modelⅠ. Conclusion BMI and intermuscular fat content of soleus have important reference value in determining the prognosis of patients with COPD at stable stage, and the latter may be superior to the former.
[1] Costa TM，Costa FM，Moreira CA，et al. Sarcopenia in COPD：relationship with COPD severity and prognosis [J]. J Bras Pneumol，2015，41（5）：415-421.
[2] Zhou T，Zhong Y，Liao J，et al. A prospective study of salvational intervention with ICS/LABA for reducing chronic obstructive pulmonary disease exacerbation under severe air pollution （SIRCAP） in Beijing：protocol of a multi-center randomized controlled trial [J]. BMC Pulm Med，2019，19（1）：22.
[3] Cosentino ER，Landolfo M，Bentivenga C，et al. Morbidity and mortality in a population of patients affected by heart failure and chronic obstructive pulmonary disease：an observational study [J]. BMC Cardiovasc Disord，2019，19（1）：20.
[4] Flynn RWV，MacDonald TM，Chalmers JD，et al. The effect of changes to GOLD severity stage on long term morbidity and mortality in COPD [J]. Respir Res，2018，19（1）：249.
[5] Cosentino ER，Landolfo M，Bentivenga C，et al. Morbidity and mortality in a population of patients affected by heart failure and chronic obstructive pulmonary disease：an observational study [J]. BMC Cardiovasc Disord，2019，19（1）：20.
[6] Vogelmeier CF，Criner GJ，Martínez FJ，et al. Global Strategy for the diagnosis，management，and prevention of chronic obstructive pulmonary disease：GOLD executive summary [J]. Am J Respir Crit Care Med，2017，195（5）：557-582.
[7] 华锋，崔恩海，林勇.BODE指数在判断慢性阻塞性肺病患者预后中的作用[J].临床内科杂志，2008，25（2）：122-123.
[8] 葛建军.体质指数与COPD患者生存预后关系的回顾性队列研究[J].实用医学杂志，2013，29（10）：1686-1688.
[9] Ho SH，Wang JY，Kuo HP，et al. Mid-arm and calf circumferences are stronger mortality predictors than body mass index for patients with chronic obstructive pulmonary disease [J]. Int J Chron Obstruct Pulmon Dis，2016，11（8）：2075-2080.
[10] Bodduluri S，Puliyakote ASK，Gerard SE，et al. Airway fractal dimension predicts respiratory morbidity and mortality in COPD [J]. J Clin Invest，2018，128（12）：5676.
[11] 张银，丁薇，赵云峰，等.胸部CT扫描测定肺动脉与主动脉直径比值在慢性阻塞性肺疾病预后中的价值[J].中国医药导报，2017，4（14）：47-50.
[12] 户良斌，杨建全.介入有氧运动及肺康复训练联合吸入舒利迭与噻托溴铵对中重度COPD患者肺功能、运动耐力及生活质量的影响[J].中国医药导报，2017，14（17）：104-107.
[13] 修麓璐，高玉芳，王会会，等.以家庭为中心的慢病管理对COPD患者自我管理及生活质量的影响[J].中国医药导报，2017，4（14）：151-154.
[14] Jones SE，Maddocks M，Kon SS，et al. Sarcopenia in COPD：prevalence，clinical correlates and response to pulmonary rehabilitation [J]. Thorax，2015，70（3）：213-218.
[15] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组.COPD诊治指南（2007年修订版）[J].继续医学教育，2007， 21（2）：31-42.
[16] 苗丽君，张瑞霞，王静，等.慢性阻塞性肺疾病患者长期预后与体质指数关系的研究[J].中华老年医学杂志，2014， 1（34）：35-38.
[17] 农成军.慢阻肺急性加重期患者预后的影响因素分析[J].中外医学研究，2017，15（11）：20-21.
[18] 伍建光，陈正贤，甘兵，等.慢性阻塞性肺疾病患者30日再入院率与体重指数的关系分析[J].中国医学创新，2018，15（9）：83-85.
[19] Beijers RJHCG，van de Bool C，van den Borst B，et al. Normal weight but low muscle mass and and abdominally obese：Implications for the cardiometabolic risk profile in chronic obstructive pulmonary disease [J]. J Am Med Dir Assoc，2017，18（6）：533-538.
[20] Robles PG，Sussman MS，Naraghi A，et al. Intramuscular fat infiltration contributes to impaired muscle function in COPD [J]. Med Sci Sports Exerc，2015，47（7）：1334-1341.
[21] Pothirat C，Chaiwong W，Phetsuk N，et al. The relationship between body composition and clinical parameters in chronic obstructive pulmonary disease [J]. J Med Assoc Thai，2016，99（4）：386-393.
[22] Swallow EB，Reyes D，Hopkinson NS，et al. Quadriceps strength predicts mortality in patients with moderate to severe chronic obstructive pulmonarydisease [J]. Thorax，2007，62（2）：115-120.
[23] Marquis K，Debigaré R，Lacasse Y，et al. Midthigh muscle cross-sectional area is a better predictor of mortality than body mass index in patients with chronic obstructive pulmonary disease [J]. Am J Respir Crit Care Med，2002，166（6）：809-813.
2019, Vol. 16 
京公网安备 11010502046598号