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Xu Y, Yan Z, Li K, Liu L, Xu L. Association between nutrition-related indicators with the risk of chronic obstructive pulmonary disease and all-cause mortality in the elderly population: evidence from NHANES. Front Nutr 2024; 11:1380791. [PMID: 39081677 PMCID: PMC11286481 DOI: 10.3389/fnut.2024.1380791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 07/01/2024] [Indexed: 08/02/2024] Open
Abstract
Background This study aims to use six nutrition-related indicators to assess the relationship between nutritional status and the risk of COPD as well as the all-cause mortality rate, and to determine the most reliable predictive indicators. Methods Data from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2013 to 2018 were extracted. Nutritional status was evaluated using Controlling nutritional status (CONUT) score, Geriatric Nutritional Risk Index (GNRI), Advanced Lung Cancer Inflammation Index (ALI), Prognostic Nutritional Index (PNI), Triglycerides (TG) × Total Cholesterol (TC) × Body Weight (BW) Index (TCBI), and Albumin-to-Globulin Ratio (AGR) nutritional-related indicators. Multivariate weighted logistic and Cox regression models were employed to assess the correlation between the six nutritional-related indicators and the risk of COPD and as all-cause mortality. The restricted cubic spline tests were applied to explore potential nonlinear relationships, and ROC curves and C-index analyses were conducted to compare the predictive capabilities of different indicators. Stratified analysis and propensity score matching (PSM) to assess the robustness of the results. Results In this study, Lower ALI, lower GNRI, and higher CONUT scores were positively correlated with an increased risk of COPD (OR: 1.77, 95% CI: 1.10-2.84) (OR: 8.66, 95% CI: 2.95-25.5), and (OR: 5.11, 95% CI: 1.72-15.2), respectively. It was found that ALI and GNRI had a non-linear relationship with the risk of COPD. After propensity score matching (PSM), the associations between ALI, GNRI, CONUT scores, and COPD remained consistent. Lower ALI, PNI, and GNRI scores were positively associated with all-cause mortality in COPD patients (HR: 2.41, 95% CI: 1.10-5.27), (HR: 3.76, 95% CI: 1.89-7.48), and (HR: 4.55, 95% CI: 1.30-15.9), respectively, with GNRI displaying a non-linear relationship with all-cause mortality. ROC curve and C-index analyses indicated that ALI had the best predictive ability for both COPD risk and all-cause mortality. Conclusion ALI, GNRI, and CONUT scores are correlated with the risk of COPD, while ALI, PNI, and GNRI scores are associated with all-cause mortality in COPD patients. Compared to other nutritional scores, ALI may provide more effective predictive value for both risk and all-cause mortality.
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Affiliation(s)
- Yifeng Xu
- School of Clinical Medicine, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
| | - Zhaoqi Yan
- School of Clinical Medicine, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
| | - Keke Li
- School of Clinical Medicine, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
| | - Liangji Liu
- Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, China
| | - Lei Xu
- Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, China
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Zhuang R, Liao J, Giri M, Wen J, Guo S. Relationship between dietary protein, serum albumin, and mortality in asthmatic populations: a cohort study. Front Immunol 2024; 15:1396740. [PMID: 39026682 PMCID: PMC11254659 DOI: 10.3389/fimmu.2024.1396740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 06/12/2024] [Indexed: 07/20/2024] Open
Abstract
Background Currently, there is limited research on the correlation between protein levels in the body and asthma. We used data from the NHANES to explore the relationship of dietary protein, serum albumin, with mortality in individuals with asthma to better understand their impact on asthma. Method This investigation involved 3005 individuals with asthma from the NHANES dataset. Studying potential links between dietary protein, serum albumin, and mortality in asthmatic populations utilized the Cox proportional hazards models, trend test, restricted cubic splines (RCS), and Kaplan-Meier survival analysis. Furthermore, subgroup analyses were carried out to explore these connections within specific populations. Result After considering all potential variables, multivariate Cox proportional hazard models proved that dietary protein intake did not have an independent connection with all-cause mortality, but serum albumin was inversely linked with all-cause mortality. Each unit rise in serum albumin (g/l) was linked to a 13% decrease in the likelihood of all-cause mortality. RCS confirmed a negative and linear connection of serum albumin with all-cause mortality. The Kaplan-Meier survival curve suggested that asthmatic adults with greater serum albumin levels had a decreased risk of mortality compared to those with lower levels. Conclusion The investigation proved a negative linear connection of serum albumin with all-cause mortality in asthma patients. However, there was no independent link discovered between dietary protein intake with mortality. This indicates that serum albumin could be a significant factor in predicting long-term outcomes for asthma patients.
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Affiliation(s)
| | | | | | - Jun Wen
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
| | - Shuliang Guo
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
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Zhao J, Zhao P. Association between serum neurofilament light chain and periodontitis. Clin Oral Investig 2024; 28:369. [PMID: 38864919 PMCID: PMC11168977 DOI: 10.1007/s00784-024-05769-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/06/2024] [Indexed: 06/13/2024]
Abstract
OBJECTIVES The association between serum neurofilament light chain (sNfL) and periodontitis remains unclear, and there is a need to examine the contribution of serum albumin (SA) in this association. The objective of the study is to investigate the correlation between sNfLand periodontitis, while examining the potential mediator role of SA in this association. METHODS The study, which included 1218 participants from the 2013-2014 National Health and Nutrition Examination Survey (NHANES), aimed to evaluate the association between sNfL and periodontitis through weighted multivariable logistic regression analysis, restricted cubic spline (RCS) models, and stratified models. In addition, mediation analysis was used to investigate the role of SA in mediating this association. RESULTS The multivariable logistic regression models revealed that sNfL was significantly linked to periodontitis (model 1: odds ratio [OR], 3.08, 95% confidence interval [CI], 1.48 to 6.39, model 2: OR, 3.69; 95% CI, 1.73 to 7.90, model 3: OR, 3.58, 95% CI, 1.52 to 8.43). The RCS models suggested a linear relationship between sNfL and periodontitis. The stratified analysis revealed no significant moderating effects (p-value > 0.05). The mediation analysis demonstrated that SA mediated the correlation between sNfL and periodontitis, with a mediation proportion of 10.62%. CONCLUSIONS The results point to sNfL being a factor in the heightened risk of periodontitis. Additionally, SA may mediate the changes in periodontitis that are associated with sNfL. CLINICAL RELEVANCE sNfL may contribute to the development of periodontitis by mediating changes in SA in humans.
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Affiliation(s)
- Jing Zhao
- Department of Central Laboratory, Affiliated Hospital 6 of Nantong University, Yancheng Xindu Road 606#, Yancheng, Jiangsu Province, PR China.
| | - Panwen Zhao
- Department of Central Laboratory, Affiliated Hospital 6 of Nantong University, Yancheng Xindu Road 606#, Yancheng, Jiangsu Province, PR China
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Wen J, Xia J, He Q, Giri M, Guo S. Association between protein intake, serum albumin and blood eosinophil in US asthmatic adults. Front Immunol 2024; 15:1383122. [PMID: 38835754 PMCID: PMC11148351 DOI: 10.3389/fimmu.2024.1383122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 04/30/2024] [Indexed: 06/06/2024] Open
Abstract
Background Presently, numerous studies have indicated that protein consumption and levels of blood albumin serve as important biomarkers for a range of respiratory illnesses. However, there have been few investigations into the correlation between protein consumption, serum albumin, and asthma. Methods Our analysis incorporated 2509 asthmatics from the 2011-2018 NHANES dataset. The investigation employed three linear regression models and XGBoost model to investigate the potential link between protein intake, serum albumin levels, and blood eosinophil counts (BEOC) in patients with asthma. The trend test, generalized additive model (GAM), and threshold effect model were utilized to validate this correlation. As well, we undertook stratified analyses to look at the correlation of serum albumin with BEOC among distinct populations. Results In the univariable regression model, which did not account for any covariates, we observed a positive correlation between protein intake and BEOC. However, univariable and multivariable regression analyses all suggested a negative connection of serum albumin with BEOC in asthma populations. In Model C, which took into account all possible factors, BEOC dropped by 2.82 cells/uL for every unit increase in serum albumin (g/L). Additionally, the GAM and threshold effect model validated that serum albumin and BEOC showed an inverted U-shaped correlation. Conclusion Our investigation discovered there was no independent link between asthmatics' protein intake and BEOC. However, we observed an inverted U-shaped relationship between serum albumin levels and BEOC, suggesting a possible relationship between the overall nutritional status of asthmatics and immune system changes. Our findings provide new directions for future research in the field of asthma management and therapy.
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Affiliation(s)
- Jun Wen
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
| | - Jing Xia
- Department of Respiratory and Critical Care Medicine, The Third Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
| | - Qingliu He
- Department of Urology, The Second Affiliated Hospital of Fujian Medical University, Fujian Medical University, Fujian, China
| | - Mohan Giri
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
| | - Shuliang Guo
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
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Wang Y, Zhang J, Zhang J, Hou M, Kong L, Lin X, Xu J, Yan C, Lin F, Ke S. Association between per- and polyfluoroalkyl substances exposure and prevalence of chronic obstructive pulmonary disease: The mediating role of serum albumin. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 925:171742. [PMID: 38494022 DOI: 10.1016/j.scitotenv.2024.171742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/05/2024] [Accepted: 03/14/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND No study has examined the association between per- and polyfluoroalkyl substances (PFAS) exposure and chronic obstructive pulmonary disease (COPD) risk. This study aims to explore this relationship. METHODS This study enrolled 4541 individuals who had available data on PFAS, COPD, and covariates from NHANES 2007-2018. Serum PFAS including perfluorohexane sulfonate (PFHxS), perfluorononanoic acid (PFNA), perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS) were analyzed, because of high detective rates. Considering the skew distribution of PFAS levels, the natural logarithm-transformed PFAS (Ln-PFAS) was used. Logistic regression analysis, restricted cubic spline (RCS), and weighted quantile sum (WQS) regression were performed to explore the single, nonlinear, and mixed effects. A mediating analysis was used to evaluate the mediated effects of albumin. RESULTS Individuals with COPD had higher levels of PFHxS, PFNA, PFOA, and PFOS compared to those without COPD. Ln-PFNA (OR males: 1.92, 95 % CI:1.31 to 2.80, P: <0.001; OR females: 1.07, 95 % CI: 0.81 to 1.40, P: 0.636) and ln-PFOA (OR males: 2.17, 95 % CI:1.38 to 3.41, P: <0.001; OR females: 1.49, 95 % CI: 1.08 to 2.05, P: 0.016) were associated with COPD risk especially in males. The interaction between PFNA exposure and sex on COPD risk was significant (P interaction: <0.001). The RCS curve demonstrated the nonlinear relationship between the ln-PFOA (P nonlinear:0.001), ln-PFNA (P nonlinear:0.045), and COPD risk in males. WQS analysis showed mixed PFAS exposure was correlated with COPD risk in males (OR: 1.44, 95 % CI:1.18 to 1.75, P: <0.001). Albumin mediated the relationship between PFOA and COPD (mediated proportion: -17.94 %). CONCLUSION This study concludes PFOA and PFNA are linked to a higher COPD risk in males, and serum albumin plays a mediating role in the relationship between PFOA and COPD. Thess findings are beneficial for the prevention of COPD. Further studies are required to explore potential mechanisms.
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Affiliation(s)
- Yan Wang
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, China
| | - Jingwen Zhang
- Department of Psychological Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian, China
| | - Jiaxian Zhang
- Department of Plastic and Aesthetic Surgery, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Miao Hou
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, China
| | - Lingkun Kong
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, China
| | - Xiong Lin
- Department of Thoracic Surgery, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, China
| | - Jinxin Xu
- Department of Thoracic Surgery, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, China
| | - Chun Yan
- Department of Thoracic Surgery, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, China
| | - Fan Lin
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, China
| | - Sunkui Ke
- Department of Thoracic Surgery, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, China.
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Berber NK, Atlı S, Geçkil AA, Erdem M, Kıran TR, Otlu Ö, İn E. Diagnostic Value of Galectin-3 in Exacerbations of Chronic Obstructive Pulmonary Disease. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:529. [PMID: 38674175 PMCID: PMC11052179 DOI: 10.3390/medicina60040529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease characterized by acute exacerbations. Systemic inflammation and oxidative stress play an important role in the pathogenesis of COPD. Exacerbations in COPD reduce the quality of life and are associated with rapid disease progression. Galectin-3 is a beta-galactoside-binding lectin of approximately 30 kDa with pro-inflammatory and pro-fibrotic properties. This study aims to analyze the efficacy of serum galectin-3 in predicting exacerbations in COPD patients. Materials and Methods: Baseline demographic and clinical characteristics of all patients were recorded and blood samples were collected. A total of 58 consecutive COPD patients, including 28 patients (19 male and 9 female) with stable COPD and 30 patients (23 male and 7 female) with acute exacerbation of COPD (AECOPD), were included in the study. Results: Serum galectin-3 levels were significantly higher in the AECOPD group compared to the stable COPD group. A logistic regression analysis revealed that increased galectin-3 levels and disease duration were independent predictors of COPD exacerbation (OR = 5.322, 95% CI: 1.178-24.052, p = 0.03; and OR = 1.297, 95% CI: 1.028-1.635, p = 0.028; respectively). Conclusions: The results of our study demonstrated that Galectin-3 was a strong and independent predictor of exacerbations in COPD patients.
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Affiliation(s)
- Nurcan Kırıcı Berber
- Department of Chest Diseases, Malatya Turgut Özal University, Malatya 44210, Turkey;
| | - Siahmet Atlı
- Department of Chest Diseases, Van Training and Research Hospital, Van 65100, Turkey;
| | | | - Mehmet Erdem
- Department of Medical Biochemistry, Malatya Turgut Özal University, Malatya 44210, Turkey; (M.E.); (T.R.K.); (Ö.O.)
| | - Tuğba Raika Kıran
- Department of Medical Biochemistry, Malatya Turgut Özal University, Malatya 44210, Turkey; (M.E.); (T.R.K.); (Ö.O.)
| | - Önder Otlu
- Department of Medical Biochemistry, Malatya Turgut Özal University, Malatya 44210, Turkey; (M.E.); (T.R.K.); (Ö.O.)
| | - Erdal İn
- Department of Pulmonary Diseases, Faculty of Medicine, İzmir University of Economics, İzmir 35330, Turkey;
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Shi M, Duan X, Zheng X, Lu D, Ge Y, Zhang N, Liu Y, You J, Xue H, Yin L. Quantification of human serum albumin by combining chymotrypsin/trypsin digestion coupled with LC-MS/MS technique. Anal Biochem 2023; 680:115316. [PMID: 37689095 DOI: 10.1016/j.ab.2023.115316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/04/2023] [Accepted: 09/06/2023] [Indexed: 09/11/2023]
Abstract
The quantification of albumin is important in clinical medicine because the concentration of albumin in biological fluids is closely related to human health. In this study, we developed a highly selective and robust assay to determine human serum albumin (HSA) in human plasma by combining chymotrypsin/trypsin digestion coupled with targeted LC-MS/MS technique. Human plasma samples were denatured, reduced, alkylated, and digested with both chymotrypsin and trypsin to generate surrogate peptides. A unique chymotryptic peptide (NAETF) arising from human serum albumin was finally selected for targeted LC-MS/MS detection and quantification. Numerous parameters related to the targeted LC-MS/MS assay were evaluated, including lower limit of quantitation (LLOQ), linearity range, enzyme digestion efficiency, accuracy and precision. The LC-MS/MS assay was linear in the concentration range 0.05-1 mg/mL with intra-day and inter-day precision <10.2% and accuracy ranging from -3.94% to 4.89%. The assay was successfully applied to determine HSA in 148 human plasma samples.
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Affiliation(s)
- Meiyun Shi
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin, 1242(21), PR China; Aim Honesty Biopharmaceutical Co. LTD, Dalian, 116600, PR China
| | - Xujian Duan
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin, 1242(21), PR China
| | - Xinyue Zheng
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin, 1242(21), PR China
| | - Di Lu
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin, 1242(21), PR China
| | - Yuncheng Ge
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin, 1242(21), PR China
| | - Ning Zhang
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin, 1242(21), PR China
| | - Yajun Liu
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin, 1242(21), PR China
| | - Jiansong You
- Aim Honesty Biopharmaceutical Co. LTD, Dalian, 116600, PR China
| | - Hongyu Xue
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin, 1242(21), PR China.
| | - Lei Yin
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin, 1242(21), PR China.
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Voulgareli I, Bakakos P, Loukides S. Exploring Mechanisms in COPD: Time for Biomarker Reappraisal? J Clin Med 2023; 12:6729. [PMID: 37959195 PMCID: PMC10649374 DOI: 10.3390/jcm12216729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 10/17/2023] [Indexed: 11/15/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a widespread condition often overlooked in diagnosis [...].
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Affiliation(s)
- Ilektra Voulgareli
- 2nd Respiratory Medicine Department, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece;
| | - Petros Bakakos
- 1st Respiratory Medicine Department, Athens Chest Hospital Sotiria, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece;
| | - Stelios Loukides
- 2nd Respiratory Medicine Department, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece;
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Zhang R, Zhang Y, Liu Z, Pei Y, He Y, Yu J, You C, Ma L, Fang F. Association between neutrophil-to-albumin ratio and long-term mortality of aneurysmal subarachnoid hemorrhage. BMC Neurol 2023; 23:374. [PMID: 37858065 PMCID: PMC10585913 DOI: 10.1186/s12883-023-03433-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 10/10/2023] [Indexed: 10/21/2023] Open
Abstract
OBJECTIVE The prognosis of aneurysmal subarachnoid hemorrhage (aSAH) survivors is concerning. The goal of this study was to investigate and demonstrate the relationship between the neutrophil-to-albumin ratio (NAR) and long-term mortality of aSAH survivors. METHODS A retrospective observational cohort study was conducted at Sichuan University West China Hospital between January 2009 and June 2019. The investigation of relationship between NAR and long-term mortality was conducted using univariable and multivariable Cox regression models. To demonstrate the predictive performance of different biomarkers over time, time-dependent receiver operating characteristic curve (ROC) analysis and decision curve analysis (DCA) were created. RESULTS In total, 3173 aSAH patients were included in this study. There was a strong and continuous relationship between NAR levels and long-term mortality (HR 3.23 95% CI 2.75-3.79, p < 0.001). After adjustment, the result was still significant (adjusted HR 1.78 95% CI 1.49-2.12). Compared with patients with the lowest quartile (< 0.15) of NAR levels, the risk of long-term mortality in the other groups was higher (0.15-0.20: adjusted HR 1.30 95% CI 0.97-1.73; 0.20-0.28: adjusted HR 1.37 95% CI 1.03-1.82; >0.28: adjusted HR 1.74 95% CI 1.30-2.32). Results in survivors were found to be still robust. Moreover, out of all the inflammatory markers studied, NAR demonstrated the highest correlation with long-term mortality. CONCLUSIONS A high level of NAR was associated with increased long-term mortality among patients with aSAH. NAR was a promising inflammatory marker for long-term mortality of aSAH.
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Affiliation(s)
- Renjie Zhang
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yu Zhang
- Center for Evidence Based Medical and Clinical Research, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China
| | - Zheran Liu
- Department of Biotherapy, Cancer Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yiyan Pei
- Department of Biotherapy, Cancer Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yan He
- Department of Biotherapy, Cancer Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jiayi Yu
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Chao You
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Lu Ma
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
| | - Fang Fang
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
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Choi YJ, Park HJ, Cho JH, Byun MK. Low Skeletal Muscle Mass and Clinical Outcomes in Chronic Obstructive Pulmonary Disease. Tuberc Respir Dis (Seoul) 2023; 86:272-283. [PMID: 37582676 PMCID: PMC10555524 DOI: 10.4046/trd.2023.0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/21/2023] [Accepted: 08/05/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND In patients with chronic obstructive pulmonary disease (COPD), decreased muscle mass is a frequently encountered comorbidity in clinical practice. However, the evaluation of muscle mass in patients with COPD in real-world practice is rare. METHODS We retrospectively reviewed the electronic medical records of all patients with COPD who underwent bioelectrical impedance analysis at least once between January 2011 and December 2021 in three hospitals. Then, we analyzed the performance rate of muscle mass measurement in the patients and the correlation between muscle mass, clinical parameters, and COPD prognosis. RESULTS Among the 24,502 patients with COPD, only 270 (1.1%) underwent muscle mass measurements. The total skeletal muscle mass index was significantly correlated with albumin, alanine transaminase, and creatinine to cystatin C ratio in patients with COPD (r=0.1614, p=0.011; r=0.2112, p=0.001; and r=0.3671, p=0.001, respectively). Acute exacerbation of COPD (AE COPD) was significantly correlated with muscle mass, especially the truncal skeletal muscle mass index (TSMI) in males (r=-0.196, p=0.007). In the multivariate analysis, TSMI and cystatin C were significant risk factors for AE COPD (hazard ratio, 0.200 [95% confidence interval, CI, 0.048 to 0.838] and 4.990 [95% CI, 1.070 to 23.278], respectively). CONCLUSION Low muscle mass negatively affects the clinical outcomes in patients with COPD. Despite its clinical significance, muscle mass measurement is performed in a small proportion of patients with COPD. Therefore, protocols and guidelines for the screening of sarcopenia in patients with COPD should be established.
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Affiliation(s)
- Yong Jun Choi
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye Jung Park
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Hwa Cho
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min Kwang Byun
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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11
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Yuan FZ, Xing YL, Xie LJ, Yang DL, Shui W, Niu YY, Zhang X, Zhang CR. The Relationship Between Prognostic Nutritional Indexes and the Clinical Outcomes of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2023; 18:1155-1167. [PMID: 37332836 PMCID: PMC10275318 DOI: 10.2147/copd.s402717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/30/2023] [Indexed: 06/20/2023] Open
Abstract
Purpose Nutritional status is related to the clinical outcomes of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The aim of this study was to investigate the association between nutritional status, measured by the prognostic nutritional index (PNI), and adverse hospitalization outcomes in patients with AECOPD. Methods Consecutive AECOPD patients admitted to the First Affiliated Hospital of Sun Yat-sen University between January 1, 2015 to October 31, 2021 were enrolled. We collected the clinical characteristics and laboratory data of patients. Multivariable logistic regression models were developed to assess the relationship between the baseline PNI and adverse hospitalization outcomes. A generalized additive model (GAM) was used to identify any non-linear relationship. In addition, we performed a subgroup analysis to tested the robustness of the results. Results A total of 385 AECOPD patients were involved in this retrospective cohort study. Based on the tertiles of PNI, patients in the lower tertiles of PNI showed more worse outcome incidence (30 [23.6%] versus 17 [13.2%] versus 8 [6.2%]; p < 0.001). Multivariable logistic regression analysis revealed that the PNI were independently associated with adverse hospitalization outcomes after adjustment for confounding factors (Odds ratio [OR] = 0.94, 95% CI: 0.91 to 0.97, P < 0.0001). After adjusting for confounders, smooth curve fitting showed a saturation effect, suggesting that the relationship between the PNI and adverse hospitalization outcomes was nonlinear. Two-piecewise linear regression model suggested that the incidence of adverse hospitalization outcomes significantly decreased with PNI level up to the inflection point (PNI = 42), and PNI was not associated with adverse hospitalization outcome after that point. Conclusion Decreased PNI levels at admission were determined to be associated with adverse hospitalization outcomes in patients with AECOPD. The results obtained in this study may potentially assist clinicians optimize risk evaluations and clinical management processes.
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Affiliation(s)
- Fu-Zhen Yuan
- Department of General Practice Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People’s Republic of China
| | - Yan-Li Xing
- Department of General Medicine, East Hospital, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510700, People’s Republic of China
| | - Liang-Jie Xie
- Department of General Practice Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People’s Republic of China
| | - Dong-Ling Yang
- Department of General Practice Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People’s Republic of China
| | - Wei Shui
- Department of General Medicine, East Hospital, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510700, People’s Republic of China
| | - Yuan-Yuan Niu
- Department of General Medicine, East Hospital, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510700, People’s Republic of China
| | - Xin Zhang
- Department of General Medicine, East Hospital, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510700, People’s Republic of China
| | - Chang-Ran Zhang
- Department of General Medicine, East Hospital, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510700, People’s Republic of China
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Antar R, Farag C, Xu V, Drouaud A, Gordon O, Whalen MJ. Evaluating the baseline hemoglobin, albumin, lymphocyte, and platelet (HALP) score in the United States adult population and comorbidities: an analysis of the NHANES. Front Nutr 2023; 10:1206958. [PMID: 37284646 PMCID: PMC10240525 DOI: 10.3389/fnut.2023.1206958] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 05/05/2023] [Indexed: 06/08/2023] Open
Abstract
Introduction As a composite immunonutritional biomarker, the Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) score has shown promise in assessing a patient's overall health status by integrating several routinely collected laboratory indicators. This biomarker has been examined in many different populations of patients and disease states (i.e., cancer), but an integrated, universal rubric using standardized thresholds has not thus far been developed. Pre-existing large population-based databases represent an ideal source to examine the distribution of HALP and the influence of diverse health statuses on this score. Methods We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) between 2017-2020, evaluating 8,245 participants across numerous demographic, socioeconomic, and health-related variables. Univariate and multivariate linear regression analyses assessed the associations between HALP scores and these factors. Results Our findings revealed significant associations between HALP scores and various demographic, socioeconomic, and health conditions. The median HALP score among the representative population was 49.0, with varying median scores across different groups and normal reference ranges for males and females. Multivariate regression analysis showed that anemia treatment, age over 65 years, weak/failing kidneys, and cancer were independent risk factors associated with lower HALP scores. Male participants demonstrated higher HALP scores than female participants, and age was inversely related to HALP. Moreover, HALP scores were negatively associated with the number of comorbidities. Conclusion/discussion This study set out to explore the HALP score from a population-based perspective, uncovering notable associations that offer vital insights into the score's clinical relevance and future applications. By determining a median HALP score of 49.0 and normal reference ranges within our diverse, representative sample, we establish a robust foundation for researchers to refine optimal HALP applications and thresholds. Considering the growing focus on personalized medicine, HALP holds promise as a prognostic tool, enabling clinicians to comprehend their patients' immunonutritional status better and deliver customized care.
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Affiliation(s)
- Ryan Antar
- Department of Urology, George Washington University School of Medicine, Washington, DC, United States
| | - Christian Farag
- Department of Medicine, George Washington University School of Medicine, Washington, DC, United States
| | - Vincent Xu
- Department of Urology, George Washington University School of Medicine, Washington, DC, United States
| | - Arthur Drouaud
- Department of Urology, George Washington University School of Medicine, Washington, DC, United States
| | - Olivia Gordon
- Department of Urology, George Washington University School of Medicine, Washington, DC, United States
| | - Michael J. Whalen
- Department of Urology, George Washington University School of Medicine, Washington, DC, United States
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Fang Q, Yu J, Luo J, Deng Q, Chen B, He Y, Zhang J, Zhou C. Combination of Baseline and Variation of Prognostic Nutritional Index Enhances the Survival Predictive Value of Patients With Advanced Non-Small Cell Lung Cancer Treated With Programmed Cell Death Protein 1 Inhibitor. Clin Med Insights Oncol 2022; 16:11795549221137134. [PMID: 36408336 PMCID: PMC9666882 DOI: 10.1177/11795549221137134] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/18/2022] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Low baseline prognostic nutritional index (PNI) scores are associated with poor survival for various malignancies; however, they vary based on the cohort and time resulting in inaccurate results. We determined the predictive value of the PNI score variations in addition to the baseline PNI scores for patients with advanced non-small cell lung cancer (NSCLC) who received programmed cell death protein 1 (PD-1) inhibitor. METHODS We retrospectively analysed 115 patients with advanced NSCLC who received PD-1 inhibitor. The median follow-up period was 28 months. Patients were clustered into four groups based on the combined PNI scores (combination of baseline and variation of PNI scores): ΔPNI-L-L, ΔPNI-L-H, ΔPNI-H-L, and ΔPNI-H-H subgroups. For instance, if PNI scores of patients with high baseline PNI score increased from baseline to 6 weeks after treatment, they were included in the ΔPNI-H-H subgroup. Cox regression models were used to identify the factors associated with survival. RESULTS The baseline PNI score was only related to the overall survival (OS) (P = .026), and not to the overall response rate (ORR) (P = .299) and progression-free survival (PFS) (P = .207). The ORR was associated with the combined PNI scores (P = .017). A multivariable Cox regression analysis confirmed that the combined PNI scores were independent factors for PFS (ΔPNI-L-H, 12 months, hazard ratio [HR] = 0.449, P = .009; ΔPNI-H-L, 14 months, HR = 0.500, P = .019; and ΔPNI-H-H, 17 months, HR = 0.390, P = .012; vs ΔPNI-L-L, 8 months) and OS (ΔPNI-L-H, 27 months, HR = 0.403, P = .019; ΔPNI-H-L, 28 months, HR = 0.369, P = .010; and ΔPNI-H-H, not reached, HR = 0.087, P = .002; vs ΔPNI-L-L, 15 months). CONCLUSIONS Patients with high baseline PNI and increased PNI score had the better survival outcome. On dynamic monitoring and comprehensive assessment, the combined PNI scores significantly enhanced the survival predictive ability of patients with NSCLC treated with PD-1 inhibitor.
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Affiliation(s)
- Qiyu Fang
- Medical College of Soochow University,
Soochow, China
- Department of Medical Oncology,
Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute,
Tongji University School of Medicine, Shanghai, China
| | - Jia Yu
- Department of Medical Oncology,
Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute,
Tongji University School of Medicine, Shanghai, China
| | - Jie Luo
- Department of Medical Oncology,
Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute,
Tongji University School of Medicine, Shanghai, China
| | - Qinfang Deng
- Department of Medical Oncology,
Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute,
Tongji University School of Medicine, Shanghai, China
| | - Bin Chen
- Department of Medical Oncology,
Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute,
Tongji University School of Medicine, Shanghai, China
| | - Yayi He
- Department of Medical Oncology,
Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute,
Tongji University School of Medicine, Shanghai, China
| | - Jie Zhang
- Department of Medical Oncology,
Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute,
Tongji University School of Medicine, Shanghai, China
| | - Caicun Zhou
- Department of Medical Oncology,
Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute,
Tongji University School of Medicine, Shanghai, China
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Tsutsumi T, Nakano D, Kawaguchi M, Hashida R, Yoshinaga S, Takahashi H, Anzai K, Kawaguchi T. MAFLD associated with COPD via systemic inflammation independent of aging and smoking in men. Diabetol Metab Syndr 2022; 14:115. [PMID: 35974418 PMCID: PMC9380323 DOI: 10.1186/s13098-022-00887-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND AIM Metabolic dysfunction and associated systemic inflammation are risk factors for chronic obstructive pulmonary disease (COPD) and COPD is highly prevalent in men. We investigated the impact of metabolic-associated fatty liver disease (MAFLD) and MAFLD-related systemic inflammation on COPD in men. METHODS We enrolled 2,041 men with fatty liver. Patients were classified into the COPD (n = 420/2041) and non-COPD (n = 1621/2041) groups. COPD and its high-risk group were diagnosed using the Japanese Respiratory Society Disease statement. Systemic inflammation was evaluated using the C-reactive protein (CRP)/albumin ratio. Independent factors for COPD were investigated by multivariate analysis and decision-tree analysis. RESULTS The prevalence of MAFLD was significantly higher in the COPD group than in the non-COPD group. In multivariable analysis, in addition to heavy smoking and aging, MAFLD was identified as an independent factor for COPD (OR 1.46, 95% CI 1.020-2.101, P = 0.0385). Decision-tree analysis showed that MAFLD, rather than heavy smoking, was the most influential classifier for COPD in non-elderly men (14% in MAFLD vs 6% in non-MAFLD groups). MAFLD was also the second most influential factor in elderly men who were not heavy smokers. In both groups, the CRP/albumin ratio was the first classifier for COPD (16% in the high CRP/albumin ratio group vs 3% in the low CRP/albumin ratio group of non-elderly men). CONCLUSIONS MAFLD is an independent predictor of COPD in men. MAFLD had a significant impact on COPD through systemic inflammation in men of all ages who were not heavy smokers. MAFLD may be useful to broadly identify COPD in men.
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Affiliation(s)
- Tsubasa Tsutsumi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
| | - Dan Nakano
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Machiko Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Ryuki Hashida
- Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan
| | - Shinobu Yoshinaga
- Medical Examination Section, Medical Examination Part Facilities, Public Utility Foundation Saga Prefectural Health Promotion Foundation, Saga, Japan
| | - Hirokazu Takahashi
- Division of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Saga, Japan
| | - Keizo Anzai
- Division of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Saga, Japan
| | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
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Shojai S, Haeri Rohani SA, Moosavi-Movahedi AA, Habibi-Rezaei M. Human serum albumin in neurodegeneration. Rev Neurosci 2022; 33:803-817. [PMID: 35363449 DOI: 10.1515/revneuro-2021-0165] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/02/2022] [Indexed: 11/15/2022]
Abstract
Serum albumin (SA) exists in relatively high concentrations, in close contact with most cells. However, in the adult brain, except for cerebrospinal fluid (CSF), SA concentration is relatively low. It is mainly produced in the liver to serve as the main protein of the blood plasma. In the plasma, it functions as a carrier, chaperon, antioxidant, source of amino acids, osmoregulator, etc. As a carrier, it facilitates the stable presence and transport of the hydrophobic and hydrophilic molecules, including free fatty acids, steroid hormones, medicines, and metal ions. As a chaperon, SA binds to and protects other proteins. As an antioxidant, thanks to a free sulfhydryl group (-SH), albumin is responsible for most antioxidant properties of plasma. These functions qualify SA as a major player in, and a mirror of, overall health status, aging, and neurodegeneration. The low concentration of SA is associated with cognitive deterioration in the elderly and negative prognosis in multiple sclerosis (MS) and amyotrophic lateral sclerosis (ALS). SA has been shown to be structurally modified in neurological conditions such as Alzheimer's disease (AD). During blood-brain barrier damage albumin enters the brain tissue and could trigger epilepsy and neurodegeneration. SA is able to bind to the precursor agent of the AD, amyloid-beta (Aβ), preventing its toxic effects in the periphery, and is being tested for treating this disease. SA therapy may also be effective in brain rejuvenation. In the current review, we will bring forward the prominent properties and roles of SA in neurodegeneration.
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Affiliation(s)
- Sajjad Shojai
- School of Biology, College of Science, University of Tehran, Tehran, Iran
| | | | | | - Mehran Habibi-Rezaei
- School of Biology, College of Science, University of Tehran, Tehran, Iran
- Nano-Biomedicine Center of Excellence, Nanoscience and Nanotechnology Research Center, University of Tehran, Tehran, Iran
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Yang D, Meng X, Wang Y, Zhang J, Zhao Y, Zheng Z, Zhang T. Effects of probiotics on gastric cancer‐related inflammation: A systematic review and meta‐analysis. J Food Biochem 2022; 46:e14034. [PMID: 35277873 DOI: 10.1111/jfbc.14034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 11/18/2021] [Accepted: 11/21/2021] [Indexed: 12/20/2022]
Affiliation(s)
- Dong Yang
- Department of Gastrosurgery Liaoning Cancer Hospital & Institute Cancer Hospital of China Medical University Shenyang China
| | - Xiang‐yu Meng
- Department of Gastrosurgery Liaoning Cancer Hospital & Institute Cancer Hospital of China Medical University Shenyang China
| | - Yue Wang
- Department of Gastrosurgery Liaoning Cancer Hospital & Institute Cancer Hospital of China Medical University Shenyang China
| | - Jun Zhang
- Department of Gastrosurgery Liaoning Cancer Hospital & Institute Cancer Hospital of China Medical University Shenyang China
| | - Yan Zhao
- Department of Gastrosurgery Liaoning Cancer Hospital & Institute Cancer Hospital of China Medical University Shenyang China
| | - Zhi‐chao Zheng
- Department of Gastrosurgery Liaoning Cancer Hospital & Institute Cancer Hospital of China Medical University Shenyang China
| | - Tao Zhang
- Department of Gastrosurgery Liaoning Cancer Hospital & Institute Cancer Hospital of China Medical University Shenyang China
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17
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He Y, Chen Y, Cao K, Zheng H. Effect of Anemia on Readmission and Death in Octogenarian Patients with Lower Respiratory Tract Infections: A Retrospective Cohort Study. Int J Clin Pract 2022; 2022:4566936. [PMID: 36349057 PMCID: PMC9633185 DOI: 10.1155/2022/4566936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/26/2022] [Accepted: 10/03/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Lower respiratory tract infection (LRTI) in the octogenarian population is a highly prevalent disorder associated with increased mortality rates. Anemia is a common disorder in older adults and is often left untreated. We investigated whether anemia was a risk factor for LRTI-caused readmission and death in octogenarian patients. DESIGN A retrospective cohort study was designed. Participants. Old patients (age: ≥80 years) hospitalized at the Department of Geriatrics to undergo treatment for LRTIs were included. A total of 215 patients (mean age: 88.73 years; 77.2% men) were studied. The patients were divided into two groups (anemia and non-anemia) based on the hemoglobin level. They were followed up for 1 year after discharge or until mortality event. The primary follow-up outcome was LRTI-caused readmission and/or death. RESULTS The risk of readmission due to LTRI within 1 year of discharge was 2.308 times higher in the anemia group than the risk for the non-anemia group. The number of patients experiencing ≥2 readmissions in the anemia group was significantly higher than that in the non-anemia group (35 (23.5%) vs. 2 (3%), P < 0.001). To prevent readmission of one case, only 2.65 cases with anemia needed to be treated. Furthermore, the risk of LRTI-related deaths was 6.644 times higher in the anemia group than the risk for the non-anemia group. To prevent death of one case, only 3.9 cases with anemia needed to be treated. Statistic results revealed that hemoglobin was an independent protective factor for LRTI-caused readmission (logistic regression method, OR, 0.969; 95% CI, 0.950-0.989) and deaths (Cox regression method, β, -0.037, HR, 0.964; 95% CI, 0.934-0.994). CONCLUSIONS Anemia is a widely prevalent and relevant risk factor associated with LRTI-caused readmission and death within 1 year of discharge in octogenarian patients. Trial Registration. This trial is registered with NCT05355324.
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Affiliation(s)
- Yu He
- Department of Geriatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ying Chen
- Department of Geriatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Hui Zheng
- Department of Geriatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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18
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Zeng X, Yang H, Yang Y, Gu X, Ma X, Zhu T. Associations of Clinical Characteristics and Intestinal Flora Imbalance in Stable Chronic Obstructive Pulmonary Disease (COPD) Patients and the Construction of an Early Warning Model. Int J Chron Obstruct Pulmon Dis 2021; 16:3417-3428. [PMID: 34955637 PMCID: PMC8694711 DOI: 10.2147/copd.s330976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 11/29/2021] [Indexed: 11/23/2022] Open
Abstract
Objective Establish a simple predictive model and scoring rule that is suitable for clinical medical staff in respiratory departments to assess intestinal flora imbalance occurrence in stable chronic obstructive pulmonary disease (COPD) patients. Methods From January 1, 2019, to December 31, 2020, COPD patients (195 cases) – who attended the Outpatient Department, Respiratory and Critical Care, Yixing Hospital, Jiangsu University – were enrolled in a cross-sectional study. Based on stool examination results, patients were divided into experimental (41 cases) and control (154 cases) groups. Single-factor and logistic regression analyses were performed with the baseline data of the two groups to obtain a new predictive model, which was further simplified. Results Five predictive factors composed the model: body mass index (BMI), serum albumin (ALB), Charlson’s Comorbidity Index (CCI), gastrointestinal symptom score (GSRs), and Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification. The model to predict intestinal flora imbalance in stable COPD patients had an area under the ROC curve (AUC) of 0.953 [95% CI (0.924, 0.982)]. After simplifying the scoring rules, the AUC was 0.767 [95% CI (0.676, 0.858)]. Conclusion In the current study, we obtained a model that could effectively predict intestinal flora imbalance risk in stable COPD patients, being suitable for implementation in early treatments to improve the prognosis. Moreover, all indicators can be easily and simply obtained.
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Affiliation(s)
- Xuetao Zeng
- Department of Respiratory and Critical Medicine, The Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu, People's Republic of China
| | - Hongfeng Yang
- Department of Critical Medicine,The Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu, People's Republic of China
| | - Yan Yang
- Department of Respiratory and Critical Medicine, The Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu, People's Republic of China
| | - Xinnan Gu
- Department of Respiratory and Critical Medicine, The Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu, People's Republic of China
| | - Xiuqin Ma
- Department of Respiratory and Critical Medicine, The Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu, People's Republic of China
| | - Taofeng Zhu
- Department of Respiratory and Critical Medicine, The Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu, People's Republic of China
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Hussain A, Choi HE, Kim HJ, Aich S, Saqlain M, Kim HC. Forecast the Exacerbation in Patients of Chronic Obstructive Pulmonary Disease with Clinical Indicators Using Machine Learning Techniques. Diagnostics (Basel) 2021; 11:829. [PMID: 34064395 PMCID: PMC8147791 DOI: 10.3390/diagnostics11050829] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 04/26/2021] [Accepted: 05/01/2021] [Indexed: 12/26/2022] Open
Abstract
Preventing exacerbation and seeking to determine the severity of the disease during the hospitalization of chronic obstructive pulmonary disease (COPD) patients is a crucial global initiative for chronic obstructive lung disease (GOLD); this option is available only for stable-phase patients. Recently, the assessment and prediction techniques that are used have been determined to be inadequate for acute exacerbation of chronic obstructive pulmonary disease patients. To magnify the monitoring and treatment of acute exacerbation COPD patients, we need to rely on the AI system, because traditional methods take a long time for the prognosis of the disease. Machine-learning techniques have shown the capacity to be effectively used in crucial healthcare applications. In this paper, we propose a voting ensemble classifier with 24 features to identify the severity of chronic obstructive pulmonary disease patients. In our study, we applied five machine-learning classifiers, namely random forests (RF), support vector machine (SVM), gradient boosting machine (GBM), XGboost (XGB), and K-nearest neighbor (KNN). These classifiers were trained with a set of 24 features. After that, we combined their results with a soft voting ensemble (SVE) method. Consequently, we found performance measures with an accuracy of 91.0849%, a precision of 90.7725%, a recall of 91.3607%, an F-measure of 91.0656%, and an AUC score of 96.8656%, respectively. Our result shows that the SVE classifier with the proposed twenty-four features outperformed regular machine-learning-based methods for chronic obstructive pulmonary disease (COPD) patients. The SVE classifier helps respiratory physicians to estimate the severity of COPD patients in the early stage, consequently guiding the cure strategy and helps the prognosis of COPD patients.
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Affiliation(s)
- Ali Hussain
- Institute of Digital Anti-Aging Healthcare, Inje University, Gimhae 50834, Korea; (A.H.); (S.A.)
| | - Hee-Eun Choi
- Department of Physical Medicine and Rehabilitation, Haeundae Paik Hospital, Inje University College of Medicine, Busan 48108, Korea;
| | - Hyo-Jung Kim
- Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan 48108, Korea;
| | - Satyabrata Aich
- Institute of Digital Anti-Aging Healthcare, Inje University, Gimhae 50834, Korea; (A.H.); (S.A.)
| | - Muhammad Saqlain
- Department of Computer Science & Engineering, Ulsan National Institute of Science and Technology, Ulsan 44919, Korea;
| | - Hee-Cheol Kim
- College of AI Convergence/Institute of Digital Anti-Aging Healthcare/u-HARC, Inje University, Gimhae 50834, Korea
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