摘要
目的 研究血清生长素释放肽(Ghrelin)、抑食肽(Obestatin)与老年慢性阻塞性肺疾病(COPD)患者营养状况及预后的关系。方法 选择2022年1月至2023年12月期间上海交通大学医学院附属瑞金医院收治的120例稳定期COPD患者且年龄≥60岁作为研究的COPD组,另取同期体检且年龄≥60岁的100例志愿者作为对照组。检测血清Ghrelin、Obestatin水平,评估微型营养评估简易法(MNA-SF)评分。根据频繁急性加重情况评估稳定期COPD患者的预后,分为频繁急性加重患者(n=54)和未频繁急性加重患者(n=66),采用logistic回归模型分析稳定期COPD患者预后的影响因素。结果 COPD组的血清Ghrelin水平高于对照组,血清Obestatin水平以及MNA-SF评分低于对照组,差异有统计学意义(P<0.05);不同肺功能GOLD分级的COPD患者血清Ghrelin比较为GOLD 1级<2级<3级,血清Obestatin水平以及MNA-SF评分为GOLD 1级>2级>3级,差异有统计学意义(P<0.05);COPD患者血清Ghrelin水平与MNA-SF评分成负相关,血清Obestatin水平与MNA-SF评分呈正相关(P<0.05);COPD组中频繁急性加重患者的血清Ghrelin水平高于未频繁急性加重患者,血清Obestatin水平、MNA-SF评分、第一秒用力呼气容积、第一秒用力呼气容积/用力肺活量低于未频繁急性加重患者,差异有统计学意义(P<0.05);血清Ghrelin水平增加是频繁急性加重的危险因素,血清Obestatin水平及MNA-SF评分增加是频繁急性加重的保护因素。结论 稳定期COPD患者血清Ghrelin增加、Obestatin降低与营养不良、预后频繁急性加重相关。
Objective To investigate the relationship between serum ghrelin,obestatin,and nutri⁃tional status and prognosis in elderly patients with chronic obstructive pulmonary disease(COPD).Methods A total of 120 patients with a stable COPD aged≥60 years who were admitted to Ruijin Hospital Affiliated with Shanghai Jiao Tong University School of Medicine from January 2022 to December 2023 were selected as the COPD group,while 100 volunteers aged≥60 years who underwent physical examinations during the same pe⁃riod were chosen as the control group.Serum levels of ghrelin and obestatin were measured,and the Mini Nutri⁃tional Assessment⁃Short Form(MNA⁃SF)was administered.The prognosis of stable COPD patients was evalu⁃ated based on frequent acute exacerbations,with patients divided into frequent acute exacerbations(n=54)and non⁃frequent acute exacerbations(n=66).A logistic regression model was used to analyze the influencing fac⁃tors on the prognosis of stable COPD patients.Results Serum ghrelin levels in the COPD group were higher than those in the control group,while serum obestatin level and MNA⁃SF score were lower than those in the con⁃trol group,the difference was statistically significant(P<0.05).The comparison of serum ghrelin in COPD pa⁃tients with different GOLD grades of pulmonary function was GOLD grade 1<2<3,and serum obestatin level and MNA⁃SF score were GOLD grade 1>2>3,the difference was statistically significant(P<0.05).In COPD patients,the serum ghrelin level was negatively correlated with the MNA⁃SF score,and the serum obestatin level was positively correlated with the MNA⁃SF score(P<0.05).Within the COPD group,the serum ghrelin levels of patients with frequent acute exacerbations were higher than that of patients without frequent acute exac⁃erbations,and the serum obestatin level,MNA⁃SF scores,forced expiratory volume in the first second,and forced expiratory volume in the first second/forced vital capacity were lower than those without frequent acute exacerbations,these differences were statistically significant(P<0.05).Increased serum ghrelin levels were identified as a risk factor for frequent acute exacerbations,whereas increased serum obestatin level and MNA⁃SF scores were protective factors against frequent acute exacerbations.Conclusion Increased serum ghrelin levels and decreased obestatin levels in stable COPD patients are associated with malnutrition and frequent acute exacerbations,impacting prognosis.
作者
徐琛莹
荣岚
卞冬生
王蕾
潘莉倩
XU Chenying;RONG Lan;BIAN Dongsheng;WANG Lei;PAN Liqian(Department of Geriatrics,Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,China,200020)
出处
《分子诊断与治疗杂志》
2025年第5期960-963,976,共5页
Journal of Molecular Diagnostics and Therapy
基金
上海市加强公共卫生体系建设三年行动计划(2023-2025年)(GWVI-11.2-YQ36)。
