Division of Epidemiology and Public Health, University of Nottingham, England.
Division of Epidemiology and Public Health, University of Nottingham, England.
Chest. 2012 Sep;142(3):712-717. doi: 10.1378/chest.11-2124.
Nutrition is an important component of clinical care for patients with cystic fibrosis. We aimed to test the hypothesis that increased BMI, height, and level of creatinine as a biomarker for lean muscle mass are associated with lower mortality and whether differences in these measures may contribute toward sex differences in survival in cystic fibrosis.
Using a cohort study design, we analyzed data from the UK Cystic Fibrosis Registry for patients who attended an annual assessment visit in 2007 and were followed-up until July 2009.
Of 1,517 individuals, 62 died during the follow-up period. The odds of death were higher among patients in the lowest quintile of serum creatinine compared with the rest of the study population (OR, 3.28; 95% CI, 1.79-5.98). Increased height and higher BMI were also associated with lower risk of death. The higher mortality in female patients (OR, 1.48; 95% CI, 0.93-2.34) was reversed by adjustment using the absolute values for height, BMI, and serum creatinine level (adjusted OR, 0.44; 95% CI, 0.21-0.90) but not by the use of sex-specific values for these exposure variables.
Lower muscle mass, shorter stature, and a low BMI are associated with increased mortality in cystic fibrosis. These measures of body habitus may contribute to the sex-specific survival differences in individuals with cystic fibrosis.
营养是囊性纤维化患者临床护理的重要组成部分。我们旨在检验以下假设,即 BMI、身高和肌酐水平(作为瘦体重的生物标志物)增加与死亡率降低相关,以及这些指标的差异是否可能导致囊性纤维化患者的生存性别差异。
使用队列研究设计,我们分析了参加 2007 年年度评估就诊并随访至 2009 年 7 月的英国囊性纤维化登记处患者的数据。
在 1517 名个体中,有 62 人在随访期间死亡。与研究人群的其余部分相比,血清肌酐最低五分位的患者死亡的可能性更高(OR,3.28;95%CI,1.79-5.98)。身高增加和 BMI 升高也与死亡风险降低相关。女性患者的死亡率较高(OR,1.48;95%CI,0.93-2.34),但通过使用身高、BMI 和血清肌酐水平的绝对值进行调整(调整后的 OR,0.44;95%CI,0.21-0.90)而不是使用这些暴露变量的性别特异性值进行调整后得到逆转。
肌肉量减少、身高较矮和 BMI 较低与囊性纤维化患者的死亡率增加相关。这些身体形态指标可能导致囊性纤维化个体的生存性别差异。