COPD“肥胖悖论”的相关混杂因素分析

Analysis of Confounding Factors Related to Obesity Paradox in COPD

摘要: 低体重指数(Body Mass Index, BMI)是慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease, COPD)患者死亡的独立危险因素，COPD的发生发展与体重减轻和骨骼肌萎缩相关。然而，目前肥胖的全球流行改变了COPD患者所观察到的营养异常的性质。近几年国内外众多研究结果提示，COPD患者同冠心病、心力衰竭、高血压、II型糖尿病一样，也存在“肥胖悖论”，即肥胖未必缩短患者的预期生存时间，对一些慢性病而言，可能反而是保护性因素。然而关于“肥胖悖论”的议题一直存在争议。这一议题对慢性阻塞性肺疾病亦非常感兴趣，也是正在进行研究的一个重要领域。但现有证据来看，肥胖与COPD之间的关系似乎更加复杂，其中多个混杂因素参与并导致了这一结果。

Abstract: Low Body Mass Index (BMI) is an independent risk factor for death in patients with Chronic Ob-structive pulmonary Disease (COPD), the development of which is associated with weight loss and skeletal muscle atrophy. However, the current global epidemic of obesity has changed the nature of the nutritional abnormalities observed in patients with COPD. In recent years, many domestic and foreign research results suggest that COPD patients, like coronary heart disease, heart failure, hypertension, type II diabetes, there is also an “obesity paradox”, that is, obesity may not shorten the expected survival time of patients, but for some chronic diseases, may be a protective factor. However, the issue of the obesity paradox remains controversial. This topic is also of great interest to chronic obstructive pulmonary disease and is an important area of ongoing research. But the available evidence suggests that the relationship between obesity and COPD is more complex, with multiple confounding factors contributing to the outcome.