Body mass index and weight loss as risk factors for poor outcomes in patients with idiopathic pulmonary fibrosis: a systematic review and meta-analysis

被引:4
作者
He, Xing [1 ,2 ]
Ji, Jiaqi [1 ]
Liu, Chi [3 ,4 ]
Luo, Zeli [5 ]
Tang, Jialong [6 ]
Yan, Haiying [1 ,2 ]
Guo, Lu [1 ,7 ]
机构
[1] Univ Elect Sci & Technol China, Sichuan Prov Peoples Hosp, Sch Med, Dept Pulm & Crit Care Med, Chengdu, Sichuan Provinc, Peoples R China
[2] Cheng Du Qing Cheng Mt Hosp, Dept Pulm & Crit Care Med, Chengdu, Sichuan Provinc, Peoples R China
[3] Sichuan Acad Med Sci, Dept Nephrol, Chengdu, Sichuan Provinc, Peoples R China
[4] Univ Elect Sci & Technol China, Sichuan Prov Peoples Hosp, Sichuan Renal Dis Clin Res Ctr, Chengdu, Sichuan Provinc, Peoples R China
[5] Chengdu Wenjiang Dist Peoples Hosp, Dept Crit Care Med, Chengdu, Sichuan Provinc, Peoples R China
[6] Jiange Cty Peoples Hosp, Dept Resp & Crit Care Med, Nanchong, Sichuan Provinc, Peoples R China
[7] Univ Elect Sci & Technol china, sichuan Prov Peoples Hosp, Sch Med, Dept Pulm & crit care Med, Chengdu 610072, sichuan Provinc, Peoples R China
关键词
Idiopathic pulmonary fibrosis; body mass index; weight loss; mortality; acute exacerbation; hospitalization; ACUTE EXACERBATION; CLINICAL CHARACTERISTICS; DISEASE; HETEROGENEITY; COMORBIDITIES; PIRFENIDONE; DIAGNOSIS;
D O I
10.1080/07853890.2024.2311845
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
ObjectiveThe association between nutritional status and prognosis of idiopathic pulmonary fibrosis (IPF) remains unclear. This systematic review and meta-analysis aimed to explore the effect of body mass index (BMI) and weight loss on the prognosis of IPF patients.MethodsWe accumulated studies on IPF, BMI, and weight loss from databases including PubMed, Embase, Web of science, Scopus, Ovid and Cochrane Library up to 4 August 2023. Using Cox proportional hazard regression model for subgroup analysis, hazard ratio (HR) and 95% confidence intervals (CI) for BMI in relation to mortality, acute exacerbation (AE), and hospitalization in IPF patients were calculated, and HR, odds ratio (OR), and 95% CI for weight loss corresponding to IPF patient mortality were assessed. Sensitivity analysis was peformed by eliminating every study one by one, and publication bias was judged by Egger's test and trim-and-fill method.ResultsA total of 34 eligible studies involving 18,343 IPF patients were included in the meta-analysis. The pooled results by univariate Cox regression analysis showed that baseline BMI was a predictive factor for IPF mortality (HR = 0.93, 95%CI = [0.91, 0.94]). Furthermore, the results by the multivariable regression model indicated that baseline BMI was an independent risk factor for predicting IPF mortality (HR = 0.94, 95%CI = [0.91, 0.98]). Weight loss was identified as a risk factor for IPF mortality (HR = 2.74, 95% CI = [2.12, 3.54]; OR = 4.51, 95% CI = [1.72, 11.82]) and there was no predictive value of BMI for acute exacerbation (HR = 1.00, 95% CI= [0.93, 1.07]) or hospitalization (HR = 0.95, 95% CI = [0.89, 1.02]).ConclusionLow baseline BMI and weight loss in the course of IPF may indicate a high risk of mortality in patients with IPF, so it is meaningful to monitor and manage the nutritional status of IPF patients, and early intervention should be conducted for low BMI and weight loss.
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页数:10
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