Chest:体重指数和肥胖与肺动脉高压患者生存之间的关系!

2018-05-25 xing.T MedSci原创

由此可见,肥胖与总人群死亡率无关,但在年轻病态肥胖患者中年龄和肥胖与死亡率增加之间存在交互作用。这些结果对年轻的病态肥胖患者主动体重管理很有意义,而这些患者是肺脏移植的候选者。

肥胖症患者死亡率较低,在心血管疾病包括肺动脉高压(PAH)中已经被描述过。近日,呼吸领域权威杂志chest上发表了一篇研究文章。研究人员的目的是明确肥胖和体重指数(BMI)是否与PAH患者的死亡率相关。

研究人员评估了来自法国PAH登记中心的特发性、药物诱导的以及遗传性PAH患者。研究人员采用Cox回归和Kaplan Meier分析评估了BMI和肥胖与全因死亡率之间的关系。

在1255例患者中,30%的参与者为肥胖患者。肥胖组中女性(65.1% vs. 53.4%,P<0.01)、药物诱导的PAH(28.9% vs. 9.2%,P<0.01)、全身性高血压糖尿病和甲状腺功能减退的比例较高。肥胖者纽约心脏协会Ⅲ级的人数更多(66.4% vs. 57.1%),Ⅳ级人数较少(11.8% vs. 16.9%)(P<0.01)、6分钟步行距离较短(276±121 vs. 324±146,P<0.01)。肥胖患者右心房压力、肺楔压和心指数较高,而肺血管阻力较低。多变量分析中,BMI(HR为0.99,95%CI为0.97-1.01,P=0.41)和肥胖(HR为1,95%CI为0.99-1.01,P=0.46)均与死亡率无关。年龄和肥胖之间存在显著的交互作用,使得65岁以下的病态肥胖患者死亡率增加(HR为3.01,95%CI为1.5-5.79,P=0.001)。

由此可见,肥胖与总人群死亡率无关,但在年轻病态肥胖患者中年龄和肥胖与死亡率增加之间存在交互作用。这些结果对年轻的病态肥胖患者主动体重管理很有意义,而这些患者是肺脏移植的候选者。

原始出处:

Jason Weatherald,et al. The association between body mass index and obesity with survival in pulmonary arterial hypertension.chest.2018.https://doi.org/10.1016/j.chest.2018.05.006

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    2019-03-19 Smile2680
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  5. 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  6. 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objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon May 28 11:15:09 CST 2018, time=2018-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=319067, encodeId=081431906ed6, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJpBl6xwMmnsKibwxcAIltOH3nnCEQbNE6TDbYtCKe8hYI0oJrbduNqnJraM1PyyjPKU1suAzicYPaA/132, createdBy=eeaf2031798, createdName=海之蓝, createdTime=Sun May 27 14:00:34 CST 2018, time=2018-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050799, encodeId=54af1050e99a2, content=肺动脉高压表面是罕见病,事实上临床上并不少见,治疗药物虽然有一些,但是整体仍然不理解,可能未来需要采用综合治疗措施。, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=明天jing, createdTime=Fri May 25 17:15:00 CST 2018, time=2018-05-25, status=1, ipAttribution=)]
    2018-05-29 惠映实验室

    学习了.谢谢分享.

    0

  7. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Tue May 29 23:40:54 CST 2018, time=2018-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=319493, encodeId=74e6319493e1, content=知之为知之.学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Mon May 28 23:53:42 CST 2018, time=2018-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=319365, encodeId=b2a631936564, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon May 28 11:15:09 CST 2018, time=2018-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=319067, encodeId=081431906ed6, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJpBl6xwMmnsKibwxcAIltOH3nnCEQbNE6TDbYtCKe8hYI0oJrbduNqnJraM1PyyjPKU1suAzicYPaA/132, createdBy=eeaf2031798, createdName=海之蓝, createdTime=Sun May 27 14:00:34 CST 2018, time=2018-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050799, encodeId=54af1050e99a2, content=肺动脉高压表面是罕见病,事实上临床上并不少见,治疗药物虽然有一些,但是整体仍然不理解,可能未来需要采用综合治疗措施。, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=明天jing, createdTime=Fri May 25 17:15:00 CST 2018, time=2018-05-25, status=1, ipAttribution=)]
    2018-05-28 易水河

    知之为知之.学习学习

    0

  8. 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objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon May 28 11:15:09 CST 2018, time=2018-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=319067, encodeId=081431906ed6, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJpBl6xwMmnsKibwxcAIltOH3nnCEQbNE6TDbYtCKe8hYI0oJrbduNqnJraM1PyyjPKU1suAzicYPaA/132, createdBy=eeaf2031798, createdName=海之蓝, createdTime=Sun May 27 14:00:34 CST 2018, time=2018-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050799, encodeId=54af1050e99a2, content=肺动脉高压表面是罕见病,事实上临床上并不少见,治疗药物虽然有一些,但是整体仍然不理解,可能未来需要采用综合治疗措施。, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=明天jing, createdTime=Fri May 25 17:15:00 CST 2018, time=2018-05-25, status=1, ipAttribution=)]
    2018-05-28 1209e435m98(暂无昵称)

    学习了.谢谢分享

    0

  9. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Tue May 29 23:40:54 CST 2018, time=2018-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=319493, encodeId=74e6319493e1, content=知之为知之.学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Mon May 28 23:53:42 CST 2018, time=2018-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=319365, encodeId=b2a631936564, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon May 28 11:15:09 CST 2018, time=2018-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=319067, encodeId=081431906ed6, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJpBl6xwMmnsKibwxcAIltOH3nnCEQbNE6TDbYtCKe8hYI0oJrbduNqnJraM1PyyjPKU1suAzicYPaA/132, createdBy=eeaf2031798, createdName=海之蓝, createdTime=Sun May 27 14:00:34 CST 2018, time=2018-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050799, encodeId=54af1050e99a2, content=肺动脉高压表面是罕见病,事实上临床上并不少见,治疗药物虽然有一些,但是整体仍然不理解,可能未来需要采用综合治疗措施。, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=明天jing, createdTime=Fri May 25 17:15:00 CST 2018, time=2018-05-25, status=1, ipAttribution=)]
    2018-05-27 海之蓝

    学习

    0

  10. 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objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon May 28 11:15:09 CST 2018, time=2018-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=319067, encodeId=081431906ed6, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJpBl6xwMmnsKibwxcAIltOH3nnCEQbNE6TDbYtCKe8hYI0oJrbduNqnJraM1PyyjPKU1suAzicYPaA/132, createdBy=eeaf2031798, createdName=海之蓝, createdTime=Sun May 27 14:00:34 CST 2018, time=2018-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050799, encodeId=54af1050e99a2, content=肺动脉高压表面是罕见病,事实上临床上并不少见,治疗药物虽然有一些,但是整体仍然不理解,可能未来需要采用综合治疗措施。, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=明天jing, createdTime=Fri May 25 17:15:00 CST 2018, time=2018-05-25, status=1, ipAttribution=)]
    2018-05-25 明天jing

    肺动脉高压表面是罕见病,事实上临床上并不少见,治疗药物虽然有一些,但是整体仍然不理解,可能未来需要采用综合治疗措施。

    0

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由此可见,4年内体重变化呈反J形的全因死亡率曲线,独立于BMI状态。体重减轻与体重增加相比,与更大的死亡率风险增加相关。

Diabetes Care:新发2型糖尿病患者的体重指数和死亡率相关性分析!

由此可见,该研究结果表明在这一领域的存在的与其他研究明显自相矛盾的发现可能受到反向因果关系的影响。长期来看,超重(BMI为25-30kg/m2)的2型糖尿病患者与对照者相比有较低的死亡率风险,而在那些BMI≥40kg/m2的患者中风险大幅增加。

SCI REP:体重指数、腰围、腰高比可预测中国老年人群多种代谢危险因素!

在这项研究中,研究人员发现BMI、WC和WHtR对多种代谢危险因素的预测要比WHpR和BAI更准确。

Lancet Diabetes Endo:糖尿病、高体重指数与多种肿瘤风险

研究发现,因糖尿病以及高体重指数导致的肿瘤患者数量相当庞大且发病率逐年上升

Neurology:体重指数、静坐时间与帕金森病风险!

由此可见,长时间久坐或肥胖与帕金森病风险无相关性。

Brit J Cancer:成年后体重指数、体力活动与多发性骨髓瘤风险!

由此可见,这些发现表明成年早期和成年后较高的BMI是MM的危险因素。